by Brianna Crandall — October 15, 2014—Infections with the intestinal superbug C. difficile nearly doubled from 2001 to 2010 in U.S. hospitals without noticeable improvement in patient mortality rates or hospital lengths of stay, according to a study of 2.2 million C. difficile infection (CDI) cases published in the October issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).
In this retrospective study from The University of Texas College of Pharmacy, researchers analyzed 10 years of data from the U.S. National Hospital Discharge Surveys (NHDS). From 2001 to 2010, rates of CDI among hospitalized adults rose from 4.5 to 8.2 CDI discharges per 1,000 total adult hospital discharges. Most CDI patients were female (59%), white (86%), and more than 65 years of age (70%).
Antibiotics
Among several factors that may have contributed to the rise in CDI incidence in recent years, antibiotic exposure is seen as the most important risk factor. According to the Centers for Disease Control and Prevention (CDC), C. difficile is the most common bacteria responsible for causing healthcare-associated infections in U.S. hospitals and is linked to 14,000 deaths each year. Reducing the use of high-risk, broad-spectrum antibiotics by 30% could lower CDI by 26%, estimates the CDC.
Infection control measures
In addition to restraint in prescribing antibiotics, the study recommends improved infection control measures, such as improved cleaning and disinfection of rooms and equipment, to help prevent patients from getting the intestinal virus while at the hospital for another reason.
Of the 2.2 million adult CDI discharges, 33% had a principal diagnosis of CDI, and 67% were classified as secondary CDI, meaning that CDI was not the primary reason they were hospitalized. Approximately 7.1%, or 154,184 patients, died during the study period.
“Our study found that peak CDI incidence occurred in 2008, with a slight decline through 2010,” said Dr. Kelly R. Reveles, one of the authors. “The leveling off of CDI incidence toward the end of our study period may be the result of increased antibiotic stewardship programs and improved infection control measures, such as use of contact precautions, cleaning and disinfection of equipment, and environment, and hand hygiene.”
