Hospital Acquired Infections and C. diff.
Frank BaileyApril 11, 2009 4:29 PM
Hospital acquired infections are on the rise in the United States. I have recently been blogging about MRSA, but today I want to address another killer, Clostridium difficile or “C. diff.”
C. diff. killed more patients in England in 2006 than MRSA, and the same virulent strain,ribotype 027 has begun to show up in some of our hospitals. So what are we to do?
Outside hospitals, C. diff. is found in about 5% of the population. It normally does not cause any problems because the other good bacteria in our gut keep it in check. The problem starts when a patient is given antibiotics. The antibiotics kill the good bacteria and C. diff. takes over causing severe diarrhea and inflammation.
The bacteria are spread in the hospital through oral-fecal contamination. A 2006 study in the Journal of Hospital Infection found that as many as one-third of blood pressure cuffs rolled from patient to patient carried C. diff. spores on the inside of the cuff. It is easy for a patient to touch their arm and then their food spreading the spores to their mouth and eventually their gut. This is especially true with patients who are fed in bed…those patients really don’t have an opportunity to wash their hands before they eat and are at risk to contract C. diff.
Cleaning is the key to stopping the spread of these deadly bacteria, but it has to be more than just routine cleaning to be effective against the C. diff. spores. Rigorous cleaning with bleach is required to disinfect rooms. Everything, bed rails, telephones, call buttons, toilet seats, and tables must be cleaned. Washing hands with soap and water is required to prevent the spread by healthcare workers. (Alcohol-based sanitizers are not as effective against C. diff. as soap and water)
Many physicians are not well versed about C. diff. A study in one hospital showed that 39% did not know the spores could be transferred from one patient to another on equipment such as stethoscopes and blood pressure cuffs.
Education of personnel about the dangers of spreading C. diff. and controlling antibiotic use are the best weapons to fight this hospital acquired infection. Treating C. diff. has been estimated to add $3.2 billion to the cost of medical care a year. What will it take to wake up hospital administrators to ensure rudimentary preventive measures are put in place and enforced?