Increased Hygiene, Motivated by COVID-19, Led to Fewer C Difficile Cases

Clostridioides difficile is the leading cause of hospital associated infections, causing an estimated $1 billion in annual healthcare costs.

Investigators with Southern Illinois University School of Medicine theorized that increased attention to infection control due to the COVID-19 pandemic would lead to decreased incidence of C difficile, which can be effectively prevented by good hand hygiene.

The investigators examined the incidence rate of C difficile in a tertiary care hospital for two full years, one before that COVID-19 pandemic and one after. Initially the study included NAAT for C. difficile, but in March 2020 the methodology changed to testing for GDH antigen and toxin A/B, to differentiate between asymptomatic colonization and infection.

Between January 1-December 31, 2019, there were 182 C difficile infections (1.29% per 1000 patient days). The next year, January 1-December 31, 2020, had a significant decrease for 51 C difficile infections (0.39% per 1000 patient days). A study of hand hygiene practices did not show a difference between the two years; both had a reported 98% compliance rate.

The investigators attributed this substantial decrease in C difficile incidence after the spread of COVID-19 to the widespread implementation of sanitation and hygiene practices. Specifically, the study named hand washing, gowning, and social distancing as contributing factors to the decrease in C difficile cases.

The study, “Association of Clostridiodes difficile Infection Incidence With Renewed Vigor in Infection Prevention Practices With the Onset of the COVID-19 Pandemic,” was virtually presented by author Ahmed A. Khan during the annual IDWeek conference.