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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.


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