<i>Clostridioides difficile</i> and Vancomycin-Resistant Enterococci in COVID-19 Patients with Severe Pneumonia

Broad-spectrum antibiotics administered to patients with severe COVID-19 pneumonia pose a risk of infection caused by <i>Clostridioides difficile</i>. This risk is reduced mainly by strict hygiene measures and early de-escalation of antibiotic therapy. Recently, oral vancomycin prophylax...

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Autores principales:	Kateřina Bogdanová, Lenka Doubravská, Iva Vágnerová, Kristýna Hricová, Vendula Pudová, Magdaléna Röderová, Jan Papajk, Radovan Uvízl, Kateřina Langová, Milan Kolář
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	COVID-19 <i>Clostridioides difficile</i> oral vancomycin prophylaxis vancomycin-resistant enterococci molecular typing of VRE ICU Science Q
Acceso en línea:	https://doaj.org/article/d70a4399caf749338b4fdd4b797431ff
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spelling	oai:doaj.org-article:d70a4399caf749338b4fdd4b797431ff2021-11-25T18:10:29Z<i>Clostridioides difficile</i> and Vancomycin-Resistant Enterococci in COVID-19 Patients with Severe Pneumonia10.3390/life111111272075-1729https://doaj.org/article/d70a4399caf749338b4fdd4b797431ff2021-10-01T00:00:00Zhttps://www.mdpi.com/2075-1729/11/11/1127https://doaj.org/toc/2075-1729Broad-spectrum antibiotics administered to patients with severe COVID-19 pneumonia pose a risk of infection caused by <i>Clostridioides difficile</i>. This risk is reduced mainly by strict hygiene measures and early de-escalation of antibiotic therapy. Recently, oral vancomycin prophylaxis (OVP) has also been discussed. This retrospective study aimed to assess the prevalence of <i>C. difficile</i> in critical COVID-19 patients staying in an intensive care unit of a tertiary hospital department of anesthesiology, resuscitation, and intensive care from November 2020 to May 2021 and the rates of vancomycin-resistant enterococci (VRE) after the introduction of OVP and to compare the data with those from controls in the pre-pandemic period (November 2018 to May 2019). During the COVID-19 pandemic, there was a significant increase in toxigenic <i>C. difficile</i> rates to 12.4% of patients, as compared with 1.6% in controls. The peak rates were noted in February 2021 (25% of patients), immediately followed by initiation of OVP, changes to hygiene precautions, and more rapid de-escalation of antibiotic therapy. Subsequently, toxigenic <i>C. difficile</i> detection rates started to fall. There was a nonsignificant increase in VRE detected in non-gastrointestinal tract samples to 8.9% in the COVID-19 group, as compared to 5.3% in the control group. Molecular analysis confirmed mainly clonal spread of VRE.Kateřina BogdanováLenka DoubravskáIva VágnerováKristýna HricováVendula PudováMagdaléna RöderováJan PapajkRadovan UvízlKateřina LangováMilan KolářMDPI AGarticleCOVID-19<i>Clostridioides difficile</i>oral vancomycin prophylaxisvancomycin-resistant enterococcimolecular typing of VREICUScienceQENLife, Vol 11, Iss 1127, p 1127 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 <i>Clostridioides difficile</i> oral vancomycin prophylaxis vancomycin-resistant enterococci molecular typing of VRE ICU Science Q
spellingShingle	COVID-19 <i>Clostridioides difficile</i> oral vancomycin prophylaxis vancomycin-resistant enterococci molecular typing of VRE ICU Science Q Kateřina Bogdanová Lenka Doubravská Iva Vágnerová Kristýna Hricová Vendula Pudová Magdaléna Röderová Jan Papajk Radovan Uvízl Kateřina Langová Milan Kolář <i>Clostridioides difficile</i> and Vancomycin-Resistant Enterococci in COVID-19 Patients with Severe Pneumonia
description	Broad-spectrum antibiotics administered to patients with severe COVID-19 pneumonia pose a risk of infection caused by <i>Clostridioides difficile</i>. This risk is reduced mainly by strict hygiene measures and early de-escalation of antibiotic therapy. Recently, oral vancomycin prophylaxis (OVP) has also been discussed. This retrospective study aimed to assess the prevalence of <i>C. difficile</i> in critical COVID-19 patients staying in an intensive care unit of a tertiary hospital department of anesthesiology, resuscitation, and intensive care from November 2020 to May 2021 and the rates of vancomycin-resistant enterococci (VRE) after the introduction of OVP and to compare the data with those from controls in the pre-pandemic period (November 2018 to May 2019). During the COVID-19 pandemic, there was a significant increase in toxigenic <i>C. difficile</i> rates to 12.4% of patients, as compared with 1.6% in controls. The peak rates were noted in February 2021 (25% of patients), immediately followed by initiation of OVP, changes to hygiene precautions, and more rapid de-escalation of antibiotic therapy. Subsequently, toxigenic <i>C. difficile</i> detection rates started to fall. There was a nonsignificant increase in VRE detected in non-gastrointestinal tract samples to 8.9% in the COVID-19 group, as compared to 5.3% in the control group. Molecular analysis confirmed mainly clonal spread of VRE.
format	article
author	Kateřina Bogdanová Lenka Doubravská Iva Vágnerová Kristýna Hricová Vendula Pudová Magdaléna Röderová Jan Papajk Radovan Uvízl Kateřina Langová Milan Kolář
author_facet	Kateřina Bogdanová Lenka Doubravská Iva Vágnerová Kristýna Hricová Vendula Pudová Magdaléna Röderová Jan Papajk Radovan Uvízl Kateřina Langová Milan Kolář
author_sort	Kateřina Bogdanová
title	<i>Clostridioides difficile</i> and Vancomycin-Resistant Enterococci in COVID-19 Patients with Severe Pneumonia
title_short	<i>Clostridioides difficile</i> and Vancomycin-Resistant Enterococci in COVID-19 Patients with Severe Pneumonia
title_full	<i>Clostridioides difficile</i> and Vancomycin-Resistant Enterococci in COVID-19 Patients with Severe Pneumonia
title_fullStr	<i>Clostridioides difficile</i> and Vancomycin-Resistant Enterococci in COVID-19 Patients with Severe Pneumonia
title_full_unstemmed	<i>Clostridioides difficile</i> and Vancomycin-Resistant Enterococci in COVID-19 Patients with Severe Pneumonia
title_sort	<i>clostridioides difficile</i> and vancomycin-resistant enterococci in covid-19 patients with severe pneumonia
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/d70a4399caf749338b4fdd4b797431ff
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<i>Clostridioides difficile</i> and Vancomycin-Resistant Enterococci in COVID-19 Patients with Severe Pneumonia

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