Incidence of Clostridioides difficile Infections across Acute Care, Long-Term Acute Care, and Rehabilitation Facilities during the COVID-19 Pandemic in Los Angeles County, California

During the first surge of the COVID-19 pandemic in 2020, hospitalized COVID-19 patients were frequently prescribed broad-spectrum antibiotics.Overuse of antibiotics can result in an imbalance of gut microbiota, which can cause antibiotic-associated diarrhea.Severe antibiotic-associated diarrhea is usually caused by a Clostridioides difficile infection (CDI).They can cause severe gastrointestinal disease and inflammation of the colon, which may lead to worse COVID-19 outcomes.Limited research has investigated the relationship between CDI and COVID-19 in a region with high population density.This study investigates the incidence of CDI across Acute Care, Long-Term Acute Care (LTAC), and Rehabilitation facilities in Los Angeles County, California, before and during the pandemic ( January 2017-December 2022).This study used data from the 2017-2022 California Department of Public Health's (CDPH) CDI database.The findings indicated that CDI's overall Standard Infection Ratio (SIR) remained relatively stable during the pandemic, with a slight increase in the SIR of LTAC facilities during the latter half of the pandemic.In the future, it is important to investigate the SIR of CDI in a large sample of LTAC facilities during COVID-19 outbreaks further.