{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T10:36:02Z","timestamp":1788258962077,"version":"build-2803163510"},"reference-count":73,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T00:00:00Z","timestamp":1634860800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009553","name":"Czech Health Research Council","doi-asserted-by":"publisher","award":["NV 18-05-00340"],"award-info":[{"award-number":["NV 18-05-00340"]}],"id":[{"id":"10.13039\/501100009553","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007059","name":"Palack\u00fd University","doi-asserted-by":"publisher","award":["IGA_LF_2020_021"],"award-info":[{"award-number":["IGA_LF_2020_021"]}],"id":[{"id":"10.13039\/501100007059","id-type":"DOI","asserted-by":"publisher"}]},{"name":"MH CZ","award":["DRO (FNOL, 00098892)"],"award-info":[{"award-number":["DRO (FNOL, 00098892)"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Broad-spectrum antibiotics administered to patients with severe COVID-19 pneumonia pose a risk of infection caused by Clostridioides difficile. This risk is reduced mainly by strict hygiene measures and early de-escalation of antibiotic therapy. Recently, oral vancomycin prophylaxis (OVP) has also been discussed. This retrospective study aimed to assess the prevalence of C. difficile in critical COVID-19 patients staying in an intensive care unit of a tertiary hospital department of anesthesiology, resuscitation, and intensive care from November 2020 to May 2021 and the rates of vancomycin-resistant enterococci (VRE) after the introduction of OVP and to compare the data with those from controls in the pre-pandemic period (November 2018 to May 2019). During the COVID-19 pandemic, there was a significant increase in toxigenic C. difficile rates to 12.4% of patients, as compared with 1.6% in controls. The peak rates were noted in February 2021 (25% of patients), immediately followed by initiation of OVP, changes to hygiene precautions, and more rapid de-escalation of antibiotic therapy. Subsequently, toxigenic C. difficile detection rates started to fall. There was a nonsignificant increase in VRE detected in non-gastrointestinal tract samples to 8.9% in the COVID-19 group, as compared to 5.3% in the control group. Molecular analysis confirmed mainly clonal spread of VRE.<\/jats:p>","DOI":"10.3390\/life11111127","type":"journal-article","created":{"date-parts":[[2021,10,24]],"date-time":"2021-10-24T22:07:11Z","timestamp":1635113231000},"page":"1127","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Clostridioides difficile and Vancomycin-Resistant Enterococci in COVID-19 Patients with Severe Pneumonia"],"prefix":"10.3390","volume":"11","author":[{"given":"Kate\u0159ina","family":"Bogdanov\u00e1","sequence":"first","affiliation":[{"name":"Department of Microbiology, University Hospital Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5354-8684","authenticated-orcid":false,"given":"Lenka","family":"Doubravsk\u00e1","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Resuscitation and Intensive Care, University Hospital Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iva","family":"V\u00e1gnerov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Microbiology, University Hospital Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9719-9989","authenticated-orcid":false,"given":"Krist\u00fdna","family":"Hricov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 779 00 Olomouc, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vendula","family":"Pudov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 779 00 Olomouc, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdal\u00e9na","family":"R\u00f6derov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 779 00 Olomouc, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9298-3096","authenticated-orcid":false,"given":"Jan","family":"Papajk","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Resuscitation and Intensive Care, University Hospital Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radovan","family":"Uv\u00edzl","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Resuscitation and Intensive Care, University Hospital Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate\u0159ina","family":"Langov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 779 00 Olomouc, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4621-8868","authenticated-orcid":false,"given":"Milan","family":"Kol\u00e1\u0159","sequence":"additional","affiliation":[{"name":"Department of Microbiology, University Hospital Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"World Health Organization (2021, August 29). Clinical Management of COVID-19: Interim Guidance, 27 May 2020. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/332196.","DOI":"10.15557\/PiMR.2020.0004"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1378\/chest.10-1396","article-title":"Community-Acquired Respiratory Coinfection in Critically Ill Patients with Pandemic 2009 Influenza A(H1N1)","volume":"139","author":"Diaz","year":"2011","journal-title":"Virus. Chest."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"420","DOI":"10.3389\/fmed.2020.00420","article-title":"Secondary Bacterial Infections in Patients with Viral Pneu-monia","volume":"7","author":"Manohar","year":"2020","journal-title":"Front. 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