Trends in Clostridioides difficile infection across a public health hospital system in New York City 2019-2021: A cautionary note


      • Healthcare facility-onset Clostridioides difficile infection across an 11-hospital system rose after the spring of 2020.
      • The reason for the increase in C. difficile infections is multifactorial.
      • The increase in C. difficile during the spring of 2020 correlated with an increase in cephalosporin use.
      Contrary to national reports, rates of healthcare facility-onset Clostridioides difficile infection across an 11-hospital system rose after the spring of 2020, when New York City was the epicenter for the COVID-19 pandemic. Antibiotic pressure from an escalation in cephalosporin usage correlated with this increase. The majority of cases of Clostridioides difficile were in patients without COVID-19, suggesting the pandemic has adversely impacted the healthcare of other inpatients.

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