Clostridium difficile, A Dangerous Superbug
|There are probably very few of us who haven’t been hospitalized at one time or another. Illnesses that you acquire during a stay in a hospital or longterm care facility are by no means new; however, in recent years, the infections have reached epidemic proportions in these institutions world wide. One of the most widespread and potentially serious of these illnesses is caused by the bacterium Clostridium difficile. This superbug is also known as Clostridium difficile Colitis, C.diff, C.difficile, Antibiotic Associated Colitis, CD, AACD and CDC.C.difficile is a rising threat. Few Americans had heard of this intestinal bug until a study sponsored by the Association for Professionals in Infection Control and Epidemiology (APIC) showed the prevalence of C.Diff is 20 times higher than previous estimates. Findings suggest that on a average day, nearly 7,200 hospitalized patients – 13 of every 100- are colonized or, more often, infected with C.diff, and about 300 patients will not survive it.C.difficile bacteria are everywhere in the environment. Three percent of healthy humans carry it in the gut, but carriage rates in hospital patients tend to be much higher, and elderly persons being treated with antibiotics are most at risk of developing infections.This happens because the antibiotics administered kill the “friendly” gut flora and C.Diff flourishes as a result. In fact, Hospital infections kill 90,000 Americans a year. These bacteria produce spores when they encounter unfavorable conditions. Transmission of infection is through the ingestion of these spores which can survive on surfaces, floors and even clothing for years and, with the exception of chlorine bleach, are resistant to many disinfectants and antiseptics, including alcohol hand gel. Do not conclude that C.difficile is confined exclusively to hospitals and similar institutions. It’s also a growing problem among otherwise healthy people and the problem is growing worse. It is, according to the Centers for Disease Control, responsible for tens of thousands of cases of diarrhea.Some people who are infected with C.difficile never become sick, though they can still spread the infection. Others have bouts of watery diarrhea with nausea and abdominal pain and cramping. And, an increasing number of persons develop severe inflammations of the colon. Complications of C.difficile infections include dehydration, kidney failure, bowel perforation, toxic megacolon and death. Signs and symptoms of this potentially life threatening illness include profuse, watery diarrhea 10 or more times a day, a fever, often greater than 101F, abdominal pain which may be severe, blood or pus in the stool, nausea, dehydration and weight loss.Although more people with no known risk factors, including children, are contracting C.difficile infections, your risk is greatest if you:
Are 65 years of age or older. Older adults have a disproportionately high infection rate.
Have a serious underlying illness or weakened immune system.
Are or have recently been hospitalized, especially for an extended period. In general, larger hospitals have higher infection rates than do smaller hospitals.
Live in a nursing home or longterm care facility. Often the infection spreads when patients are transferred from hospitals to other facilities.
Have had abdominal surgery.
Have a chronic colon disease such as inflammatory bowel disease or colorectal cancer.
Take prescription or over-the-counter antacids. By reducing stomach acid, these drugs may allow C.difficile to pass more easily into the intestine.
Have had a previous C.difficile infection.
Among the steps you can take to stop C.difficile from infecting you is to take antibiotics only when absolutely necessary and, even then, ask your Doctor to prescribe one that has a narrow range that you take for the shortest period of time so as to disrupt intestinal bacteria the least. You my also consider Probiotic Supplements which help replace beneficial bacteria that antibiotics destroy. Only Saccharomyces boulardi has proved effective in C.difficile infections however. Last of all, the simplest and one of the best preventatives is to wash, wash, wash your hands! See Hand Washing 101 article on this same Health Alerts Page.
To learn more, Consumers Union offers information on states requiring hospitals to report infection rates. Go to www.stophospitalinfections.org/learn.html and click on “State Hospital Infection Disclosure Laws.” Also, the Leapfrog Groups website www.leapfroggroup.org provides ratings of 1,300 U.S. hospitals and information on infection prevention measures. You can also Google the Centers for Medicare & Medicaid Services, at hospitalcompare.hhs.gov that reports quality information on hospitals. The Committee to Reduce Infection Deaths, hospitalinfection.org. and finally, the Society for Healthcare Epidemiology of America. Go to shea-online.org and click on “Patient Guides.”
Society for General MicrobiologyMayo Clinic
The Association for Professionals in Infection Control and Epidemiology