Impact of COVID-19 pandemic on toxinogenic Clostridioides difficile infections and correlation with multidrug-resistant bacterial infections

Clostridioides difficile infection (CDI) is one of the most common healthcare-associated infections, contributing to significant morbidity and mortality, particularly in hospitalized patients. Its incidence is influenced by infection control measures, antimicrobial stewardship, and hospital hygiene protocols. The Coronavirus disease 2019 (COVID-19) pandemic led to the widespread adoption of stringent infection prevention strategies. These measures may have influenced the incidence of CDI. At the university hospital Policlinico Umberto I in Rome, we conducted a retrospective analysis of CDI cases across three periods: preCOVID-19, COVID-19 and postCOVID- 19. Our findings revealed a statistically significant decrease in CDI cases during the COVID-19 period compared to the preCOVID-19 period, as well as in the postCOVID-19 period compared to the COVID-19 period. Additionally, we explored the potential association between CDI and multidrug-resistant organisms (MDRO). Our findings indicate a reduction in MDRO infections among patients with CDI in the COVID-19 and postCOVID-19 periods compared to the preCOVID-19 period. These results highlight the potential impact of infection control strategies on CDI incidence and suggest a possible relationship between CDI and MDRO infection. Further research is needed to assess the long-term effects of these measures and their implications for future infection prevention strategies.