CDC Warns Of Increasing Clostridium Difficile Infections

OPB | March 06, 2012 7:25 a.m. | Updated: July 17, 2012 1:02 a.m. | Portland, OR

The U.S. Centers for Disease Control and Prevention asked health officials Tuesday to take more precautions against a type of stubborn infection they've found in a wide variety of medical facilities.

Kristian Foden-Vencil looks at what's happening in Oregon.

C. difficile infections occur when someone is taking antibiotics.

The antibiotics destroy the good bacteria that usually protect patients, leaving C. difficile bacteria to take over.

Essentially the symptoms are diarrhea. That may not sound too bad, but for the elderly it can be deadly. The CDC associates C. difficile with 14,000 deaths a year.

The bacteria can be killed relatively easily, ironically enough with antibiotics. But the spores are hardy.

The author of the report, CDC epidemiologist Dr. Clifford McDonald, says the spores aren't killed by hand washing -- even with antibacterial soap -- and they can last months out in the open.

"In the past a lot of C. difficle infections were considered to happen just generally in the community. But this report shows that most of these so called community infections actually occur in people with recent exposure to medical facilities."

Dr. Ileana Arias, the deputy director of the CDC, says the good news is that C. difficile infections are very preventable.

"From a single clinician prescribing unnecessary antibiotics, to a nurse or a doctor who doesn't recognized C. difficile symptoms  and doesn't order a test. Or a hospital aide forgetting to raise gloves while raising a C. difficile patient's bed. To medical teams that don't alert each other to C. difficile's infections during patient transfers. We all have a role to play in stopping C. difficile."

CDC officials say recent efforts by the health care industry have reduced most hospital-associated infections. But C. difficile is bucking the trend.

Hospital stays from C. difficile have tripled in the last decade.

The CDC studied infections in three states and has now developed a list of six things medical centers should do.

They include: reducing the use of antibiotics; testing for C. difficile when patients have diarrhea; isolating patients; wearing gloves and gowns when treating C. difficile patients; cleaning rooms with bleach; and notifying the new facility when a C. difficile patient is transferred.

Gretchen Morley, the director of health analytics at the Oregon Health Authority, says here medical centers are already taking preventive steps.

"Most hospitals are using bleach for disinfecting surfaces at their facility. They're immediately placing patients with diarrhea on contact precautions even before lab results come back. We also found that a majority of hospitals have a specific person or persons responsible for antibiotic use. So there's a number of things that the provider community and the state are doing about this."

Oregon started requiring hospitals to report C. difficile infections in January. The feds won't require that for another year.