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CDC: Deadly and preventable C. difficile infections at all-time high
March 6th, 2012
05:18 PM ET

CDC: Deadly and preventable C. difficile infections at all-time high

The number of people being hospitalized for Clostridium difficile (C. difficile) has tripled in the past 10 years according to a new report from the Centers for Disease Control and Prevention. While other infections commonly spread in health care settings have been going down over the past decade, C. difficile infections are at "historically high and unacceptable levels," according to the CDC's Principal Deputy Director, Ileana Arias.

"C. difficile is causing many Americans to suffer and die,"  Arias says.  The CDC estimates about 14,000 people each year die from these infections, which can be treated if caught early.

The new CDC report finds that 94% of all C. difficile infections are connected to medical care settings, impacting patients not just in hospitals but also in nursing homes, doctors offices and other outpatient settings. The report finds that infections are being moved from one facility to another as infected patients get moved and necessary precautions to prevent the spread aren't taken. The CDC estimates about one-quarter of patients develop symptoms while in a hospital, the other 75% get sick in nursing homes, clinics or doctors offices.

C. difficile symptoms include (sometimes deadly) diarrhea, fever, loss of appetite, nausea, belly pain and tenderness.

C. difficile is a bacterium which forms spores and these spores can persist in the environment, survive on surfaces like hand rails, bathroom fixtures or medical equipment for months, People who are currently or who recently were taking antibiotics are the most vulnerable for getting sick, says medical epidemiologist and lead study author Dr. Clifford McDonald. That's because antibiotics not only destroy bad bacteria, but also good bacteria that protect from other infections, opening the door for a C. difficile infection.

For example: A patient may go to the doctor with an existing infection like pneumonia and will get a prescription for an antibiotic. That patient is now vulnerable for other C. difficile infections for several months. If this patient finds himself in a hospital for some reason and comes in contact with a worker who has not properly washed his hands or touched something with the bacteria on it or treated another patient with an existing C. difficile infection and isn't wearing gloves, then the now vulnerable patient can be infected. The now infected patient will likely develop diarrhea and if he in turn doesn't wash his hands properly can spread it elsewhere, let's say at nursing home where he lives.

Clifford says about while about half of the infections occur in people under the age of 65, more than "90% of deaths occur in people 65 and older."

C. difficile can be treated with specific antibiotics. But patients need to be tested for it and if they test positive and get transferred to other facilities like a nursing home or dialysis center, those health care settings need to be notified about the patient's infection.

"Illness and death linked to this deadly disease do not have to happen," says CDC Director Dr. Thomas Frieden.  The CDC recommends health care providers takes the following steps to help prevent the spread of the infection:

1. Prescribe antibiotics only when absolutely necessary. The CDC says 50% of antibiotic prescriptions are not needed.
2. Test for C. difficile if a patient has diarrhea while taking antibiotics or had been taking them within the past several months.
3. Put patients testing positive for C. difficile in isolation.
4. Health care workers need to wear gloves and gowns when taking care of infected patients. (McDonald says that commonly used hand sanitizers do not kill C.difficile bacteria.)
5. Clean room surfaces with bleach or other EPA-approved cleaners that will kill the C-difficile spores.
6. When patients are transferred to other settings, notify the facility about the patient's diagnosis so necessary precautions can be made.

Patients can also help slow the spread of this potentially deadly infection by doing the following:

1. Only take antibiotics as prescribed by physicians.
2. Tell your doctor if you develop diarrhea while taking antibiotics or within a few months after taking the drugs.
3. Thoroughly wash your hands with soap after using the bathroom.
4. Try using a separate bathroom (if possible), if you have diarrhea. If that's not possible, try to thoroughly clean all surfaces to prevent spores from lingering and infecting someone else.


soundoff (48 Responses)
  1. @askanepi

    We need new ideas and direction in order to stop nosocomial infections such as C. diff and HA-MRSA. If companies can compete for millions in funding to build a tourist spaceship why can't millions of dollars be offered to solve such basic issues such as hand washing accountability among healthcare workers? Any takers?

    March 7, 2012 at 08:55 | Report abuse | Reply
    • scubabike420

      Trying to "solve" medical problems is what has caused these infections in the first place. This article only touches on the fact that C. diff infections only occur in people who's normal gut flora has been destroyed by antibiotics. Solution, don't take antibiotics. Better yet, live a lifestyle which naturally supports a health immune system. Not eat processed foods and sugar.

      Antibiotic resistant MRSA has been traced to pigs. Pigs are regularly fed antibiotics where MRSA developed its antibiotic resistance. Now it infects people. Solution, ban the use of antibiotics in livestock. Better yet, return to sustainable farming where livestock is raised in an environment where disease in livestock is minimal.

      March 7, 2012 at 09:20 | Report abuse |
    • NavyDoc17

      The answer is of course, $. There's no money in preventing disease, and thus no incentive to do it.

      March 7, 2012 at 13:51 | Report abuse |
    • Jean

      I think that a big part of the problem is our for-profit health care system. If the "owners" of a facility see that the dividends aren't high enough, one of the first things cut is lower level staff like nurses' aides and LPNs. This, of course, puts a heavier load on the remaining staff who then have to rush to adequately care for their increased patient load. Lather, rinse and repeat, then handwashing and such become rushed. Plus, chances are cleaning staff are cut, too, with the same thing happening.

      No, I'm not a nurse or anything. Just been in the hospital years ago when it was really well staffed, and had family in there more recently when it wasn't. What a difference!

      March 7, 2012 at 18:49 | Report abuse |
  2. J Marm

    I was diagnosed with C diff one year ago. My infectious disease Dr. has me on one antibiotic every other day to keep the problem "at bay". There is no doubt, although I have no other symptoms, that the intestinal landscape has changed for me. However, I refuse to let it keep me down and keep active in my 70's. Where did I pick it up at? I am a persistent hand washer and use those wipes in stores, etc.

    March 7, 2012 at 09:26 | Report abuse | Reply
    • Teresa

      I'm so sorry you have this. Ask your doctor if it would be ok to try kefir if you haven't already. It has 10 active cultures instead of one or two some yogurts have. It's been around for hundreds of years. It's 99% lactose free. I like Lifeway brand, but there are others. I'm sure they are all good. I would try it if dr says its ok. It's not a miracle, but it's helped me a lot.

      March 7, 2012 at 11:26 | Report abuse |
    • uncommon sense

      Those wipes are usually alcohol based and kill 99% of bacteria. Cdiff is in the 1% the alcohol wipes don't kill. Many hospital staff don't even know this.
      I also had a second doctor tell me today that everyone carries c-diff, which is untrue. Only about 2-3% of the adult population carries c-diff.

      January 15, 2014 at 23:30 | Report abuse |
    • Sarah

      Start with the Fecal Transplant as a "cure" and look it up. Go from there, backwards, and connect the dots, but if I read correctly, the overuse and over perscribed antibiotics, seem to be the cause of the spread of c diff. After you take an antibiotic it may (if not needed or perscribed properly) not only kill the unhealthy bacteria in your GI tract, but also the bacteria that is necessary to keep things like this at bay. Very simply put, Jane gets sick, Jane gets antibiotic, jane gets all GI bacteria killed off, Jane gets recurring bouts of c diff. Now, in my case, 14 years later, I am just finding out what is going on :(

      February 26, 2014 at 02:01 | Report abuse |
  3. Michael

    CNN – see this previous article of yours for a solution:

    http://money.cnn.com/2012/01/26/technology/xenex_robot/index.htm

    March 7, 2012 at 11:07 | Report abuse | Reply
  4. Pam

    how does one get tested?

    March 7, 2012 at 11:48 | Report abuse | Reply
    • sosanguine

      Usually through at stool sample. If you are concerned you should see your doctor. Generally patients have a mucous-y, distinctly malodorous stool when they have c-dif. I see a lot of this in the hospital where I work, even though anyone coming through the doors with any type of diarrhea gets tested for it. Just like the article says, don't rely on hand sanitizers, wash the good old fashioned way with warm soap and water, especially after visiting the bathroom!

      March 7, 2012 at 12:04 | Report abuse |
    • jps

      Keep in mind that having C. diff in your system isn't necessarily going to make you sick - it's when you take antibiotics that kill the "good" bacteria, allowing the C. diff to thrive and grow.
      The primary take-home message is 1. Don't take antibiotics unless you really need them; 2. Make sure your docs and nurses wash their hands before they touch you or someone you love, especially in the hospital. Hand sanitizer is generally not effective on C. diff.
      Also, wash your own hands often, but not just because of C. diff. So far, it is primarily a healthcare-acquired infection, mainly in hospitals.
      And as someone else pointed out, we should probably stop wasting antibiotics on cows and pigs. They are just breeding superbugs. I buy organic milk for that very reason. It also tastes a lot better.

      March 7, 2012 at 16:05 | Report abuse |
  5. MFM

    There is an extraordinarily effective treatment for c.difficile as well as other major bowel infections. You have to get over the 'ick' factor, but stool transplants are 95%+ effective.

    The affected individual does what is basically a coloscopy prep (clear out their bowel and start with a mostly clean slate). A donor (family member) provides a 'sample' which the doctor liquifies into a slurry. The ill person is sedated (or not) and the slurry is applied to their insides much like an enema.

    All this does is replace the local flora, and in the case of c. difficile, outcompetes it with healthier flora. All the yogurt in the world can't put back what needs to be there for an adult. Only a few doctors are doing this now, but hopefully we'll all get over it and accept that, despite the grossness, this is a far safer, cost effective method. Plus, it's a cure.

    March 7, 2012 at 12:30 | Report abuse | Reply
  6. Annie

    After dealing with C. Diff for two years (on countless rounds of antibiotics and drinking kefir, taking every type of probiotic on the shelf, etc.) I finally had the stool transfer. It was no big deal and done by colonoscopy (which, afer having c. diff is also no big deal!) I have now tested negative for 3 months. The infection did leave me with a horrible case of IBS, though. I wouldn't wish any of this on my worst enemy!

    March 7, 2012 at 13:22 | Report abuse | Reply
  7. sick n tired

    Soooo... it's not bad enough that the doctors can't help you unless you spend thousands of dollars that your crummy insurance company won't cover but they also endanger you even more. I have nearly given up on the entire medical community. Can't afford the tests, can't afford the "care". I know the CEO of my crappy health insurance company can. What a disgrace our health care system is......

    March 7, 2012 at 13:32 | Report abuse | Reply
  8. Sarah

    I am 18 years old. i have now had this for 4 1/2 months. i have been on 4 different rounds of meds. the last 2 were the 'strongest'. this is absolutly hell. and yal are worring me about what could become a step in the future. dont ever wish this upon anyone.

    March 7, 2012 at 14:45 | Report abuse | Reply
  9. Tom

    I have a simple solution. Fake Canadian ID cards. Go up to Canada and get yourself checked out!

    March 7, 2012 at 15:09 | Report abuse | Reply
    • uncommon sense

      You apparently aren't too familiar with Canada's healthcare system. Most of my relatives up there are half dead by the time they get to actually get treated by Canada's "free" healthcare system.

      January 15, 2014 at 23:36 | Report abuse |
  10. just wrong

    eat grass fed animals from local farms and farmers market fruits and vegetables...avoid proccessed foods as much as possible. avoid antibiotics for as long as possible. try natural "cures" for certain ailments.

    March 7, 2012 at 15:37 | Report abuse | Reply
  11. Bucko

    I came down with C dif after taking Clindamycin for a tooth infection. This was NOT fun! Clindamycin taken in Mar 11. C dif diagnosed in late Jul 11. Took vancomycin orally several times daily from early Aug thru Dec with a C dif relapse twice. Guess it's called "difficile" for a reason!

    March 7, 2012 at 16:46 | Report abuse | Reply
  12. wendy5

    copper in hospitals; it is a conductor of germs i read about it a few months ago it was a study they did

    March 7, 2012 at 16:49 | Report abuse | Reply
  13. annie

    I wonder why we have this problems in hospitals, etc......have you been in one lately. Dirty, dirty, dirty....had to call 3 times for someone to clean the bathrooms and ended up using the public wahrooms. They were much cleaner. I know all hospitals are trying to cut costs but maybe they can buy Lysol in bulk.

    March 7, 2012 at 18:21 | Report abuse | Reply
    • J

      I work in a hospital and while cleanliness can contribute to the spread of c. dif, it is usually poor handwashing along with the overuse of antibiotics that are the main culprits. Anytime you are on an antibiotic, you need to repopulate your gut flora with probiotics. It also is unfortunate but Big Meat feeds tons of antibiotics to our food source.
      A lot of retail meat that you buy at the store is contaminated with c dif, mrsa, and lord only knows what else.

      April 14, 2012 at 16:08 | Report abuse |
  14. Lee

    I must of had that the beginning of February for 3 weeks. Couldn't eat, didn't have the need to eat, diarrhea; tired had to take antibotics that made me sick 3 times a day for 10 days. I survived and don't want to deal with that anymore.

    March 7, 2012 at 18:35 | Report abuse | Reply
  15. auntie_cipation

    Why is no one talking about probiotics? As soon as you are done with a course of antibiotics for whatever reason, take some probiotics to build back up the good bacteria.

    March 7, 2012 at 19:58 | Report abuse | Reply
  16. c dif survivor

    agree with auntie_cipation I.had recurrent c-dif a few years ago post intestinal surgery.I was on antibiotics about 4 months along with probiotics.I took a 50 billion liquid dose of probiotics, called Biok+, each day with a 2 hour separation from antibiotics. Biok+ is available at wholefoods, Sprouts and certain vitamin stores, I.still take a lower dose of the biok+ today ( 15 billion/day.).Our gut houses billions upon billions of bacteria, so 50 billion is not out of line.It was my md that recommended me to take the probiotics during the antibiotic course of treatment...I hope this will help those of you with cdif or recovering from cdif.....

    March 7, 2012 at 20:35 | Report abuse | Reply
  17. Michelle

    I had this 11 years ago after giving birth. I had straight Penicillin during labor, which made me easily contract this. Since it was childbirth, blame lies directly with anyone who had their hands anywhere near me that day. They failed to diagnose this and treated me for a uterine infection (more antibiotics), an unknown infection (5 days of 3 different IV antibiotics) and ultimately gave me a D&C for whatever reason. It took 4 trips to the ER before I finally went to a different hospital where I was properly diagnosed. Four rounds of Vancomycin did nothing. I was 32 years old with a newborn and was told there was nothing else they could do. This went on for 4 months. Finally, out of desperation, I called an on-call G/I doc on a weekend. He sounded very young, fresh out of med school. He told me to get some Acidophilus and take 2 pills every 4 hours... well over the recommended dosage. I was feeling better in 24 hours and back to normal in about 3 days. I wish I knew who that doc was. I never got to thank him for unknowingly saving my life.

    March 8, 2012 at 21:34 | Report abuse | Reply
  18. Christopher

    As a cdiff survivor i can tell u from personal experience that the antibiotics clindamycin and to a lesser extent doxycyline can be triggers for it..I was very lucky..my gi doc was very specific about the risk after surgury..after one day of having several loose bowel movements in a hours time,with a heavy putrid medcinal odor..i got tested....48 hours later i was on vancomycin 250mg every 6 hours for 10 days..7 days later i was retested..negative..Early detection is key. Eat yogurt every day..Rigorous handwashing is a must. Many elderly people can re-infect themselves by improper hygeine. Another safety tip is to use the antibiotic flagyl instead of clindamycin if possible for colo-rectal surgury. Flagyl is safer

    March 8, 2012 at 23:01 | Report abuse | Reply
  19. David

    One of the challenges with this infection is that the lab test sensitivity for the bacterial toxin can be as low as 63%. This means patients are often cared for, or transferred to other care facilities, with active C. difficile infection but negative test results. Hopefully the new tests being developed will help in the very near future (I think the new glutamate dehydrogenase test will have a 97% sensitivity).

    March 9, 2012 at 00:44 | Report abuse | Reply
  20. Marion K.

    I contracted c.diff. 6 years ago while helping to care for a paralyzed (GBS) friend confined to a critical care unit. The hospital staff didn't know my friend's diarrhea was c.diff., until the day after I started having symptoms. At the advice of my naturopathic physician, I stayed home and took probiotics of 20 billion organisms twice a day, along with the standard dose of Chinese herbal-medicine "curing pills." My diarrhea and other symptoms cleared up within 48 hours. I cleaned my bathroom with bleach solution; went on taking the probiotics for a full two weeks, but was able to return to other activities within a few days, as soon as we were certain it was gone. My paralyzed friend was treated with vancomycin in the hospital and it took a month to clear the infection; we all had to take strict isolation measures during that time. I asked her family to consent to putting probiotics in her feeding tube, but they were completely unfamiliar with such measures and refused. Fortunately, she eventually recovered and also made a good recovery from her temporary paralysis.

    March 9, 2012 at 01:52 | Report abuse | Reply
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  23. Mary

    I dealt with recurrent c diff for 3 1/2 months. I had read this blog and became very worried about my health and concerned how I would ever get over the c-diff. I had been on 3 rounds of flagyl and one of vancomycin. The vancomycin may have been the drug that really helped but I feel it was the other measures I took that finally cured me. I was desperate for help. I do not use a chiropractor but I asked for one's advice. 20 billion probiotics in the morning 1/2 hour before you eat is important and not taken at the same time as your meds for c-diff. The probiotics need to contain sacchromyces boulardii. 20 billion again before you go to bed. A good multivitamin and an immunity booster (more vitamins). I did not eat wheat, dairy or sugar for a month. I love sugar and didn't think I could do this but I was desperate. There are plenty of health food stores to shop at and find wheat free and dairy free products. I spent over $200 on pills but it worked! YOU CAN DO THIS! I DID! I am happy to be back to normal and living a happy life. I never had one back adjustment but I believe the research that chiropractors do to work on natural and preventative measures work!

    June 27, 2012 at 09:41 | Report abuse | Reply
  24. Frank

    I too was concerned with this disease. There is an excellent reference of doctors talking about this disease in the Apple app store (iTunes) called c. diff report. It seems . Some of the videos are quite technical, however, I would imagine a doctor would find the references informative. It was released by a company called Optimer.

    July 25, 2012 at 12:24 | Report abuse | Reply
  25. leslie rorbach

    We think I've had c-dif for at least seven months. I already had severe colitis so we thought that the diarea, nausea, fever and chills, headaches, numbness in feet and hands were all related to the colitis. I suffered for about four months when one of my many doctors suggested I do a stool sample just to see. Of course I was c-diff positive with toxin B. First I took vancomycin which by day five I had unusual bruising all over my body then ended up in an ambulance with a severe allergic reaction. Then I was put on Flagyl which didn't work either. Then it was suggested I have a PICC line for IV Flagyl which I did for fourteen days every eight hours. Unfortunately, I am still c-diff positive. I am now scheduled to meet with a doctor that specializes in fecal transplants on October 4th. I have been so sick and am looking very forward to having this procedure done. If anyone has had a fecal transplant for c-diff please let me know everything. My family and I just want our life back.

    September 15, 2012 at 19:14 | Report abuse | Reply
    • Robin M.

      Please let us know how it goes. I currently have c. diff and can't shake it, and I'm starting to get desperate...the squeamishness of fecal transplant is minor in comparison to the awfulness of all this...

      October 2, 2012 at 17:06 | Report abuse |
  26. Elaine

    Six days after starting amoxycillin for a sinus infection I developed severe diarrhea, abdominal pain and bloating. I was 1300 miles from home on a car trip and had to go to the ER. The hospital had a great protocol, tested me quickly, ran other tests to rule out other ailments, and admitted me for 4 days. I ran a temp of 101.8 at first. I took Flagyl for 10 days, vancomycin for my 4 days inpatient, IV fluids and potassium tabs for severe dehydration, and had to rest a lot for about 3 or 4 weeks. The diarrhea went away very slowly over a period of weeks. I found a blog in which patients mentioned a probiotic called saccharomyces boulardii and began taking that along with another probiotic with a lot of strains. The boulardii had to be ordered as no local stores sold it. I believe this helped. I am 69, female, generally healthy, and had not taken an antibiotic for about 15 years prior to the one that began my c diff odyssey.

    October 19, 2012 at 11:26 | Report abuse | Reply
  27. Sandy

    A member of our family died from C.diff recently. If your C. diff returns after the initial Flagyl/Metronidazole treatment, insist on ORAL Vancomycin immediately. Do not waste valuable time with a second Flagyl/Metronidazole treatment, and do not accept intravenous Vancomycin, which is not effective at all for C.diff.

    Remember that you can get C. diff without having been on antibiotics, and also without having diarrhea symptoms. If you or a loved one has been in a hospital recently, even if you are just visiting someone, you can be exposed to C.diff.

    Please take the time to read the CNN report "Don't let a hospital kill your child," which has C. diff prevention advice for all ages, at http://www.hospitalinfection.org/PDF/cnnhealth.pdf. The Committed to Reduce Infection Deaths is also a great source of prevention tips at http://www.hospitalinfection.org/.

    October 20, 2012 at 21:44 | Report abuse | Reply
    • Lynn`

      I am so sorry for your loss. My heart goes out to you but thank you so much for the information. Blogs like this one help me with valuable information. I asked my Dad's Doctor this morning about the pill form of the V. antibiotic and she said he has been on it. My Dad is 83 and in the VA hospital in San Antonio. They have been awesome in his care but I knew nothing about this when they first told me. I have never seen diarrhea this bad in anyone in my life so it has been very scary. I am getting the Dr. to put him on probiotics, pill form and I will also be sure he is getting the good yoghurt type stuff with the good bacteria. I also asked about the fecal transplant and they do it here is there is a re-occurence so that made me happy..

      February 20, 2013 at 11:30 | Report abuse |
  28. Sherry

    I just finished 5 weeks of Vnc last Tuesday 10/13. I became infected while in the hospital after a heart attack during the first week of October. Three days later, I spent 8 days in the ICU. I've since been hospitalized a total of 4 times and it's being blame on diabetic gastroparesis. I've been sick for almost 2 years with something that couldn't be diagnosed and would manage to fight it off, but the "attacks" lasted longer and longer to the point that I could only eat jello and chix noodle soup. I've had a low grade fever for 2 years and nothing ever showed up in the dozens of stool tests. and other GI tests It was diagosed by a flexible sigmoid while I was initially in the ICU. The dr's are telling me that there's "no way!' that I've fought this for 2 years. My family and I believe otherwise! There is a very expensive antibiotic called Difficid that is only used after many courses of Vanc. Insurance will fight you every step of the way as far as paying for it, but some things are worth fighting for. I've disinfected everything in my house possible with Clorox and it needs to be a 55% or higher solution. I pray for all of you that you will recover quickly. I'm keeping the stool transfer in mind, but I will have to have sedation. I did for the sigmoid also because all I could do was constantly wretch and use the bathroom. I was also afraid that any more pain might cause another heart attack. If I can be "cured" and be able to have a life again – and eat a little bit more- I will deal with this terrible infection.

    November 18, 2012 at 16:01 | Report abuse | Reply
    • Sarah

      I believe you!! 14 years now, and honestly this is the only thing that fits for me...there is a cure out there, I am trying to aim for it, after this long, I honestly believe my life is at risk with unknown cause for gastroparesis and function down to 7%, I am running out of time, and same as you, not sure how to keep fighting this, as it does kill!! The cure, is a fecal transplant, or the fecal transplant pill, both 90 to 100% effective, the pill being 100%, is now FDA approved. Problem is, who wants to talk about poo?! Not the general public, so this is not getting out there fast enough, good luck, and hope this gets figured out for you and me both!!

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  33. Ila

    I also have c-dif! 3rd time in 3 months- I am 36 year old and have been healthy all my life! From January until July I was improperly diagnosed and treated over and over again with various antibiotics for a sinus infection come to find out it was a root in my tooth that was cracked- after I had surgery to have tooth fixed I was put on clindamyacin low and behold I'm on my 3rd round of meds!! First was the flagyl then vancomycin 2x- I feel like I'm dying... I am confused as to why my infectious disease doctor would not opt to go ahead with the transplant at this point!! I just pray everyday I can live to watch my 1 year old grow up!!! This is horrendous

    September 18, 2013 at 23:59 | Report abuse | Reply
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