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Dangerous Bacteria Also Spreads Outside Hospitals: CDC

TUESDAY March 6, 2012 -- The dangerous bacteria Clostridium difficile spreads not only in hospitals but also in other health-care settings, causing infections and death rates to hit "historic highs," U.S. health officials reported Tuesday.

"C. difficile is a deadly diarrheal infection that poses a significant threat to U.S. health care patients," Ileana Arias, principal deputy director at the U.S. Centers for Disease Control and Prevention, said during a morning news conference. "C. difficile is causing many Americans to suffer and die."

The bacterium is linked to about 14,000 deaths in the United States every year. People most at risk from C. difficile are those who take antibiotics and also receive care in any medical facility.

"This failure is more difficult to accept because these are treatable, often preventable deaths," Arias said. "We know what can be done to do a better job of protecting our patients."

Much of the growth of this bacterial epidemic has been due to the overuse of antibiotics, the CDC noted in its March 6 report. Unlike healthy people, people in poor health are at high risk for C. difficile infection.

Almost 50 percent of infections are among people under 65, but more than 90 percent of deaths are among those aged 65 and older, according to the report.

Previous estimates find that about 337,000 people are hospitalized because of C. difficile each year. Those are historically high levels and add at least $1 billion in extra costs to the health care system, the CDC said.

However, these estimates might not completely reflect C. difficile's overall impact.

According to the new report, 94 percent of C. difficile infections are related to medical care, with 25 percent among hospital patients and 75 percent among nursing home patients or people recently seen in doctors' offices and clinics.

Although the proportion of infection is lowest in hospitals, they are at the core of prevention because many infected patients are transferred to hospitals for care, raising the risk of spreading the infection there, the CDC said.

Half of those with C. difficile infections were already infected when they were admitted to the hospital, often after getting care at another facility, the agency noted.

The other 50 percent were related to care at the hospital where the infection was diagnosed.

The CDC said that these infections could be reduced if health care workers follow simple infection control precautions, such as prescribing fewer antibiotics, washing their hands more often and isolating infected patients.

These and other measures have reduced C. difficile infections by 20 percent in hospitals in Illinois, Massachusetts and New York, the CDC noted.

In England, these infections have been cut 50 percent in three years, they added.

Patients get C. difficile infections mostly after taking antibiotics, which can diminish the body's "good" bacteria for several months.

That's when patients can get sick from C. difficile, picked up from contaminated surfaces or spread by health care providers.

The predominant sign of C. difficile infection is diarrhea, which can cause dehydration. If serious, the infection can become deadly. Other symptoms include fever, nausea and loss of appetite.

The CDC advised that if diarrhea occurs after a patient starts antibiotics, C. difficile should be suspected and treatment continued with another antibiotic.

Commenting on the report, infectious disease expert Dr. Marc Siegel, an associate professor of medicine at New York University, said that, "All these recommendations are fine; the problem is they are not going to work, you can't stop these practices. This bug exists in a climate of overuse of antibiotics."

It is hard to eradicate C. difficile because it buries itself in the colon, then recurs and testing isn't always accurate, Siegel said: "It's a pervasive problem in hospitals, and even in communities."

More information

For more about C. difficile infection, visit the U.S. Centers for Disease Control and Prevention.

Posted: March 2012


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