Symptoms, Treatment, and Outcomes of COVID-19 Patients Coinfected with Clostridioides difficile : Single-Center Study from NE Romania during the COVID-19 Pandemic.

Autor:	Stămăteanu LO; Department of Internal Medicine II, Faculty of Medicine, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania.; 'St. Parascheva' Clinical Hospital of Infectious Diseases, 700116 Iași, Romania., Miftode IL; Department of Internal Medicine II, Faculty of Medicine, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania.; 'St. Parascheva' Clinical Hospital of Infectious Diseases, 700116 Iași, Romania., Pleșca CE; Department of Internal Medicine II, Faculty of Medicine, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania.; 'St. Parascheva' Clinical Hospital of Infectious Diseases, 700116 Iași, Romania., Dorneanu OS; 'St. Parascheva' Clinical Hospital of Infectious Diseases, 700116 Iași, Romania.; Department of Preventive Medicine and Interdisciplinarity, Faculty of Medicine, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania., Roșu MF; 'St. Parascheva' Clinical Hospital of Infectious Diseases, 700116 Iași, Romania.; Department of Intensive Care Unit, Infectious Diseases Clinical Hospital, 700115 Iași, Romania., Miftode ID; Department of Radiology, 'St. Spiridon' Emergency Clinical Hospital, 700111 Iași, Romania., Obreja M; Department of Internal Medicine II, Faculty of Medicine, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania.; 'St. Parascheva' Clinical Hospital of Infectious Diseases, 700116 Iași, Romania., Miftode EG; Department of Internal Medicine II, Faculty of Medicine, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania.; 'St. Parascheva' Clinical Hospital of Infectious Diseases, 700116 Iași, Romania.
Jazyk:	angličtina
Zdroj:	Antibiotics (Basel, Switzerland) [Antibiotics (Basel)] 2023 Jun 22; Vol. 12 (7). Date of Electronic Publication: 2023 Jun 22.
DOI:	10.3390/antibiotics12071091
Abstrakt:	The Coronavirus disease 2019 (COVID-19) pandemic has brought new challenges across medical disciplines, particularly in infectious disease medicine. In Romania, the incidence of SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) infection increased dramatically since March 2020 until March 2022. Antibiotic administration for pulmonary superinfections in COVID-19 intensified and, consequently, increased rates of Clostridioides difficile infection (CDI) were hypothesized. We conducted a single-center, retrospective, observational study on patients from North-Eastern Romania to assess clinical characteristics and outcomes of COVID-19 and Clostridioides difficile (CD) coinfection, and to identify risk factors for CDI in COVID-19 patients. The study enrolled eighty-six CDI and COVID-19 coinfected patients admitted during March 2020-February 2021 (mean age 59.14 years, 53.49% men, 67.44% urban residents) and a group of eighty-six COVID-19 patients. On admission, symptoms were more severe in mono-infected patients, while coinfected patients associated a more intense acute inflammatory syndrome. The main risk factors for severe COVID-19 were smoking, diabetes mellitus, and antibiotic administration. Third generation cephalosporins (55%) and carbapenems (24%) were the main antibiotics used, and carbapenems were significantly associated with severe COVID-19 in patients coinfected with CD during hospitalization. Coinfection resulted in longer hospitalization and poorer outcomes. The extensive use of antibiotics in COVID-19, particularly carbapenems, contributed substantially to CD coinfection. Competing Interests: The authors declare no conflicts of interest.
Databáze:	MEDLINE
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