Forget MRSA for a Moment, Clostridium Difficile is a Growing Problem

Wall Street Journal
Posted by Jacob Goldstein

With all the attention on antibiotic-resistant staph, or MRSA, you may have overlooked Clostridium difficile, the nasty bacterium behind a growing number of hospital-acquired infection. Turns out C. diff is infecting more than 1 in 100 inpatients, a nationwide survey just found.

APIC, the big infection-control group, asked its members to take a one-day snapshot of C. diff in U.S. hospitals; responses came back from more than 600 facilities in 47 states.

A day in the life of C. diff proved sobering. Thirteen of every 1,000 hospitalized patients are colonized with C. diff, and 94% of those patients show signs of C. diff disease, such as severe diarrhea. The finding suggests that, on any given day, some 7,000 hospital patients have C. diff, and about 300 will go on to die of the disease, the authors wrote.

The one-day-snapshot method is somewhat unusual, so it’s tough to compare these findings with C. diff numbers from earlier studies. But by any measure, it’s clear that C. diff is a growing problem. Check out this analysis, which found that the percentage of hospital patients with C. diff doubled between 2000 and 2005.

C. diff has the nasty habit of flourishing after patients are treated with broad-spectrum antibiotics, which wipe out the intestinal bacteria that normally keep C. diff in check. And it forms hardy spores that are difficult to kill — alcohol-based disinfectant gels, for example, don’t do the trick. What’s more, a recently discovered strain called NAP1 is not only especially virulent, but also appears to pass more easily from person to person than other strains of C. diff.

So what can be done? Solid isolation and hygiene by hospital personnel helps. So does avoiding broad-spectrum antibiotics when possible, and keeping the course of treatment short. For more tips, see this WSJ story.