An often deadly and hard-to-treat infection called Clostridium difficile is at an all-time high in the United States and hospitals must act urgently to get it under control, federal health officials said on Tuesday.
The bacteria, called C. difficile or C. diff for short, kills 14,000 Americans a year by causing untreatable diarrhea, the Centers for Disease Control and Prevention said. And virtually every case is caught in the hospital.
“From 2000 to 2009, the number of hospitalized patients with any C. difficile infection discharge diagnoses more than doubled, from approximately 139,000 to 336,600, and the number with a primary C. difficile infection diagnosis more than tripled, from 33,000 to 111,000,” the CDC wrote in a special report.
“Although the incidence of other health care–associated infections has declined, C. difficile infections have increased and only recently plateaued,” the agency added. “Deaths related to C. difficile increased 40 percent between 2000 and 2007, due in part to a stronger germ strain."
C. diff is especially hard to treat and prevent because it forms strong little spores that survive stomach acid. And they aren’t killed by alcohol or standard cleaners, making it hard to eradicate them in hospitals. Bleach can kill C. diff, so the CDC recommends using bleach-based cleaners.
“C. difficile infections cost at least $1 billion in extra health care costs annually,” the CDC said.
Patients become susceptible to C. diff when they are given long courses of antibiotics, or when antibiotics are used inappropriately.
“C. difficile infection most often requires a one–two punch of antibiotics plus medical care,” the CDC’s Dr. Clifford McDonald told reporters in a telephone conference. “Antibiotics destroy good bacteria that typically protect us from infection, leaving the door open for C. difficile to take over. If a person swallows C. difficile spores during this time of vulnerability, they can become infected. This usually happens in health care facilities, after a patient picks up invisible C. difficile spores from contaminated surfaces or if a health care provider directly spreads the spores to a patient and then the patient touches his or her face.”
In January, the Agency for Healthcare Research and Quality reported that Clostridium difficile cases leveled off between 2008 and 2009 after tripling between 1993 and 2008. And the CDC said 71 hospitals and three states lowered infections by 20 percent with careful control measures.
“How did they do that? Well, it involved engagement of the hospital leadership,” McDonald said. “It involved using these recommended practices, educating on them, and ... these hospitals share with one another under these –– we call these collaboratives, these prevention programs, where they share with one another how they implemented them. And finally, they use data for action.”
The Obama administration recommends these measures as it targets hospital infections, hoping to reduce them and save lives and money.