6:10pm

Tue March 6, 2012
Shots - Health Blog

Deaths From Dangerous Gut Bacteria Hit Historic Highs

Originally published on Tue March 6, 2012 7:19 pm

Federal health officials Tuesday called on hospitals, nursing homes, clinics and doctors' offices to work harder to fight the spread of a dangerous bacterial infection that can cause life-threatening diarrhea and other complications.

While other health-care related infections have been decreasing in recent years, cases of Clostridium difficile, or C. diff, continue rising, according to Clifford McDonald of the federal Centers for Disease Control and Prevention.

"It is a bacterium that also happens to form spores that produce toxins that affect the colon, the large intestine," Clifford said.

According to a new report from the CDC, the number of Americans getting infected and hospitalized with C. diff has more than tripled, and the number dying has quadrupled in recent years. About 14,000 Americans die each year from the infection, according to the CDC.

"It is now at historic highs," McDonald said.

C. diff tends to hit people who are taking antibiotics for some other illness. The antibiotics wipe out other beneficial microbes, increasing the chances that C. diff will make them sick.

"Sometimes we talk about this as a one-two punch," McDonald said.

Ironically, most C. diff cases can be traced to an encounter with the health care system.

"They come in contact with C. difficile maybe directly from the environment — a patient bed rail or something like that — or a health care worker may carry it to them on their hands," McDonald said. "Then that patient, wherever that organism is now living on their skin — perhaps they touch their face, they swallow it. It passes into their intestine, where it causes symptoms and disease."

Doctors had long thought most people get C. diff from hospitals. But it turns out that half of patients who have C. diff are already infected before they get to the hospital.

"This is a problem not just in hospitals but wherever health care is being delivered now, very commonly in nursing homes and outpatient settings," he said.

Federal officials are urging health care workers to take several measures to try to stop C. diff from spreading. For one thing, doctors can use antibiotics a lot more sparingly. And once a patient had been diagnosed, patients should be isolated to minimize the chances they'll spread the germ to other patients, the CDC says.

Doctors, nurses and other health care workers should also wear gloves and gowns, wash their hands regularly and take other steps to prevent them carrying spores to other patients.

In addition, health care facilities should also sterilize everything an infected patient has come into contact with to eliminate any spores, which can contaminate areas for months.

"It's the spore that's the infective form," McDonald said.

Despite the sobering trends, McDonald says he is optimistic. Dozens of hospitals around the country have beaten back their C. diff infection rates by being more aggressive.

Copyright 2013 NPR. To see more, visit http://www.npr.org/.

Transcript

ROBERT SIEGEL, HOST:

Federal health officials have issued a new report about a dangerous bacterial infection. Despite years of efforts, the infection is continuing to spread rapidly. The report calls on hospitals, nursing homes and doctors' offices to fight it more aggressively, as NPR's Rob Stein reports.

ROB STEIN, BYLINE: The infection is called Clostridium difficile, or C. diff. It can cause severe diarrhea and other life threatening complications. Clifford McDonald is with the Centers for Disease Control and Prevention.

CLIFFORD MCDONALD: It is a bacterium that also happens to form spores that produces toxins that affect the colon, the large intestine.

STEIN: According to the CDC, the number of Americans getting infected and hospitalized with C. diff has more than tripled and the number dying has quadrupled in recent years. About 14,000 Americans die each year from C. diff.

MCDONALD: It is now at historic highs.

STEIN: C. diff tends to hit people who are taking antibiotics for some other illness. The antibiotics wipe out beneficial microbes, increasing the chances C. diff will make them sick.

MCDONALD: Sometimes, we talk about this as a one-two punch.

STEIN: Ironically, pretty much all C. diff cases can be traced to an encounter with the health care system. Here's how it can happen.

MCDONALD: They come in contact with C. difficile, maybe directly from the environment, a patient bedrail or something like that or a health care worker may carry it to them on their hands. Then that patient, wherever that organism now is living on their skin, perhaps they touch their face, they swallow it, it passes into their intestines, where it develops, causes symptoms and disease.

STEIN: Doctors had long thought most people get C. diff from hospitals, but it turns out that half of patients who have C. diff are already infected before they get to the hospital.

MCDONALD: This is a problem - not just in hospitals, but wherever health care is being delivered, now very commonly in nursing homes and outpatient settings.

STEIN: So federal officials are urging health care workers to take several measures to try to stop C. diff from spreading. For one thing, doctors can use antibiotics a lot more sparingly and, once a patient has been diagnosed...

MCDONALD: Get them in isolation, a separate patient room, separate bathroom. And then use gloves and gowns to prevent contaminating the hands of the health care provider in carrying it to another patient.

STEIN: McDonald says health care facilities should also sterilize everything an infected patient has come into contact with. That's because the C. diff spores can hang around for months.

MCDONALD: And it's that spore which is the infective form.

STEIN: Despite the sobering trends, McDonald says he's optimistic. Dozens of hospitals around the country have beaten back their C diff. infection rates by being more aggressive.

Rob Stein, NPR News. Transcript provided by NPR, Copyright NPR.