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U.S. hospital incidence of C. difficile soars

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Reuters Health

Wednesday, April 23, 2008

WASHINGTON (Reuters) - Federal government figures show a steep spike in U.S. cases of a common but serious infection that gives hospital patients sometimes deadly diarrhea and blood poisoning.

They show a 200 percent increase in the number of hospital patients infected with Clostridium difficile, or C. difficile, from 2000 to 2005.

The U.S. Agency for Healthcare Research and Quality tracked more than 2 million cases of C. difficile in U.S. hospitals between 1993 and 2005. Its figures show the latest jump follows a 74 percent rise in the number of cases from 1993 to 2000.

Clostridium can cause mild diarrhea or an often deadly illness that can be treated only by completely removing the colon. Two out of three infected hospital patients in 2005 were elderly, the AHRQ found.

People carry C. difficile on their hands, like other bacteria, and spread it when they touch objects, including hospital beds, equipment and doors. It forms spores that are not killed by alcohol hand sanitizers but can be destroyed with bleach.

Incontinent patients and those who have been treated for the infection before are among the likely carriers, experts have found. Other recent studies have shown C. difficile bacteria are commonly spread by unhygienic practices in hospitals.

In Britain, doctors have been discouraged from wearing white coats after studies suggested their long sleeves might pick up and spread the bugs.

The AHRQ study found that patients with C. difficile were hospitalized almost three times longer than uninfected patients and 9.5 percent died in hospital compared with 2.1 percent of patients overall.

The AHRQ team uses statistics from the Nationwide Inpatient Sample, a database of hospital inpatient stays that covers 90 percent of all discharges in the United States.

The most commonly used antibiotic for C. difficile is metronidazole, but some severe and antibiotic-resistant forms must be treated with vancomycin.

Like other bacteria, C. difficile can also acquire resistance to vancomycin, making treatment difficult or impossible.


Reuters Health

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