by Brianna Crandall — April 2, 2012—A new report from the U.S. Centers for Disease Control and Prevention (CDC) concerning the serious infections that people acquire while being treated in medical facilities shows that, unlike previously believed, not all Clostridium difficile infections originate in hospitals; rather, about 25% of C. difficile infections first show symptoms in hospital patients, and 75% first show in nursing home patients or in people recently cared for in doctors’ offices and clinics.
Although the report shows that most types of health care-associated infections (HAIs) are declining, the type caused by the germ C. difficile remains at historically high levels. C. difficile causes diarrhea linked to 14,000 American deaths each year. Those most at risk are people, especially older adults, who take antibiotics and also get medical care. Since antibiotics not only kill harmful germs but infection-fighting germs as well for several months, patients can get sick during this time from C. difficile picked up from contaminated surfaces or spread from a health care provider’s hands.
According to the report, C. difficile infections cost at least $1 billion in extra health care costs annually, and are linked to 14,000 deaths in the United States each year. Deaths related to C. difficile reportedly increased 400% between 2000 and 2007, due in part to a stronger germ strain. Almost half of infections occur in people younger than 65, but more than 90% of deaths occur in people 65 and older.
The report also shows that C. difficile germs move with patients from one health care facility to another, infecting other patients. Half of all hospital patients with C. difficile infections have the infection when admitted and may spread it within the facility. The most dangerous source of spread to others is patients with diarrhea. Unfortunately, unnecessary antibiotic use in patients at one facility may increase the spread of C. difficile in another facility when patients transfer, and when a patient transfers, health care providers are not always told that the patient has or recently had a C. difficile infection, so they may not take the right actions to prevent spread.
However, the report asserts that C. difficile infections can be prevented. Early results from hospital prevention projects show 20% fewer C. difficile infections in less than 2 years with infection prevention and control measures. In addition, England decreased C. difficile infection rates in hospitals by more than half in three years by using infection control recommendations and more careful antibiotic use.
CDC cautions clinicians and care providers to prescribe and use antibiotics carefully, to test for C. difficile when patients have diarrhea while on antibiotics or within several months of taking them, to isolate patients with C. difficile immediately, to wear gloves and gowns when treating patients with C. difficile, even during short visits, since hand sanitizer does not kill C. difficile and hand washing may not be sufficient, and to notify the new facility of the C. difficile infection when an infected patient transfers.
CDC recommends that personnel providing cleaning services for affected rooms clean room surfaces with bleach or another spore-killing disinfectant approved by the U.S. Environmental Protection Agency (EPA) after a patient with C. difficile has been treated there.
