'Remarkable drop' in C. difficile infections at Canadian hospitals
Better testing, more judicious use of antibiotics after outbreaks 10 years ago may have helped
In a study published Monday in the Canadian Medical Association Journal, researchers report that hospital-associated C. difficile infections dropped by 36 per cent between 2009 and 2015.
Improvements in infection control measures, such as improved testing, more judicious use of antibiotics, frequent hand-washing and more frequent, intense cleaning of hospital facilities in the last decade may have contributed to the drop in infection rates, he said.
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C. difficile is the most common infectious cause of diarrhea in hospitalized patients in developed countries, leading to severe illness and in some cases death. Seniors and people taking antibiotics are most vulnerable to the infection.
C. difficile bacteria produce a toxin, which causes inflammation of the colon. The microbe also creates difficult-to-eradicate spores, which can contaminate surfaces in hospital rooms and rapidly spread the infection.
NAP1, which is resistant to fluoroquinolone antibiotics, has been responsible for a number of hospital-associated outbreaks over the years, including a Quebec epidemic that began in 2002. Over the next few years, thousands of patients developed the disease and at least 2,000 died.
"What's special about NAP1 ... is [its] ability to produce a lot more toxin," said Katz, noting that spores produced by the strain are much harder to destroy through cleaning than "regular germinating bacteria."
Infection leaves patients in debilitated state
A total of 20,623 cases of hospital-associated C. difficile occurred during the network's study period, mostly in hospitals with more than 200 beds. Over that seven-year timeframe, 158 deaths were attributed to the infection, mostly among older people.
Dr. Christine Lee, an infectious disease physician and medical microbiologist at St. Joseph's Hospital in Hamilton, was not surprised to see the national drop in the number of C. diff infections, an occurrence mirrored at her hospital and others in the region.
Concerted effort to prevent infections
Lee said C. difficile not only causes symptoms like severe diarrhea, but the infection often recurs in patients, despite treatment.
"I've had some women who were asked not to come to visit to see their grandchildren," said Lee. "That is heart-breaking to hear."
"To have such a remarkable drop over such a small number of years is great news," Katz said.