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OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has induced a reinforcement of infection control measures in the hospital setting Here, we assess the impact of the COVID-19 pandemic on the incidence of nosocomial Clostridioides difficile infection (CDI) METHODS: We retrospectively compared the incidence density (cases/10,000 patient-days) of healthcare facility-associated (HCFA) CDI in a tertiary hospital in Madrid (Spain) during the maximum incidence of COVID-19 (11 March to 11 May 2020) with the same period of the previous year (control period) We also assessed the aggregate in-hospital antibiotic use (defined daily doses [DDD] per 100 occupied bed-days [BD]) and incidence density (movements/1000 patient-days) of patient mobility during both periods RESULTS: A total of 2337 patients with reverse transcription-polymerase chain reaction-confirmed COVID-19 were admitted to the hospital during the COVID-19 period Twelve HCFA CDI cases were reported at this time (incidence density of 2 68/10,000 patient-days), whereas 34 HCFA CDI cases were identified during the control period (incidence density 8 54/10,000 patient-days) (P= 000257) Antibiotic consumption was slightly higher during COVID-19 (89 73 DDD/100 BD) than during the control period (79 16 DDD/100 BD) The incidence density of patient movements was 587 61/1000 patient-days during the control period and significantly lower during the COVID-19 period (300 86/1000 patient-days) (P< 0001) CONCLUSIONS: The observed reduction of approximately 70% in the incidence density of HCFA CDI in a context of no reduction in antibiotic use supports the importance of reducing nosocomial transmission by healthcare workers and asymptomatic colonised patients, reinforcing cleaning procedures and reducing patient mobility in the epidemiological control of CDI
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Infect_Control_Hosp_Epidemiol
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Impact of the COVID-19 pandemic on nosocomial Clostridioides difficile infection
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