Clostridioides difficile infections are the main cause of antibiotic-related diarrhea. Most of them come in the form of healthcare-associated Clostridioides difficile infections (HA-CDI). The aim of the study was to analyze HA-CDI epidemiology and the relationship between antibiotic consumption and CDI epidemiology at St Luke’s Provincial Hospital in Tarnow, Poland. In 2012–2018, surveillance of CDI was carried out in adult surgical wards at St Luke’s Provincial Hospital. The data were collected in accordance with the methodology of the Healthcare-Associated Infections Surveillance Network (HAI-Net), European Centre for Disease Prevention and Control (ECDC), and the ATC/DDD system (Anatomical Therapeutic Chemical Classification System) of the World Health Organization. In total, in the study period, 51 cases of CDI involved CA-CDI (24.5%) and 147 were HA-CDIs (75.5%). The most CA-CDIs were found in the general surgery (32.6%) and urology (17.0%) wards. CA-CDI incidence was 0.7/1000 patients and for HA-CDI it was 2/1000 patients (4.4/10,000 patientdays (pds)). The highest HA-CDI incidence was in the neurosurgical departments (18/10,000 pds) and oncological surgery (8.4/10,000) pds. There was a significant positive correlation between CA-CDI and HA-CDI (correlation of 0.943, p < 0.001) and between the number of patients hospitalized and HA-CDI (correlation of 0.865, p = 0.012). The total antibiotic consumption amounted to 0.7 DDD/10,000 pds; it was the highest in the urology ward (0.84/10,000 pds) and 49.5% of the antibiotics were fluoroquinolones (0.41/10,000 pds). On the basis of regression coefficients, a positive correlation was demonstrated between the use of fluoroquinolones and the HA-CDI incidence rate. Both a high percentage of CDI cases and a high intake of antibiotics were recorded in the urology department. About half of all antibiotics were fluoroquinolones.

中文翻译：

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外科成人患者泌尿科的长期抗生素预防和难辨梭状芽胞杆菌感染的高发病率。

艰难梭菌感染是抗生素相关性腹泻的主要原因。它们大多数以与医疗保健有关的艰难梭菌的形式出现感染（HA-CDI）。这项研究的目的是分析波兰塔尔诺夫的圣卢克省立医院的HA-CDI流行病学以及抗生素消耗与CDI流行病学之间的关系。2012-2018年，在圣卢克省医院的成人外科病房对CDI进行了监测。数据是根据医疗保健相关感染监测网络（HAI-Net），欧洲疾病预防和控制中心（ECDC）和世界ATC / DDD系统（解剖化学分类系统）的方法收集的卫生组织。在研究期间，总共有51例CDI涉及CA-CDI，占24.5％，其中147例是HA-CDI，占75.5％。在普通外科病房（32.6％）和泌尿科病房（17.0％）中发现最多的CA-CDI。CA-CDI发生率为0。7/1000位患者，而HA-CDI为2/1000位患者（4.4 / 10,000病人日（pds））。HA-CDI发生率最高的是神经外科部门（18 / 10,000 pds）和肿瘤外科部门（8.4 / 10,000）pds。CA-CDI和HA-CDI之间存在显着的正相关（相关系数为0.943，p < 0.001）和住院患者数与HA-CDI之间（相关系数0.865，p = 0.012）。抗生素总消费量为0.7 DDD / 10,000 pds；它是泌尿科病房中最高的（0.84 / 10,000 pds），并且49.5％的抗生素是氟喹诺酮类药物（0.41 / 10,000 pds）。根据回归系数，氟喹诺酮类药物的使用与HA-CDI发生率之间呈正相关。泌尿科记录了高百分比的CDI病例和高剂量的抗生素。所有抗生素中约有一半是氟喹诺酮类。