The number of death certificates issued in England and Wales in 2006 mentioning Clostridium difficile (C. diff) increased to 6,480.
Figures released by the Office for National Statistics (ONS) in the United Kingdom show a significant growth in the number of death certificates indicating Clostridium difficile (C. diff) as a factor in hospital deaths. In 2006 there were 6,840 certificates issued showing mention of the infection. The figure for 2001 was 1,200.
Accuracy of reporting has been attributed as one of the reasons for the statistical increase.
Professor Brian Duerden, chief microbiologist at the Department of Health, had previously called for more accurate reporting of infections such as C. diff.
“These statistics from 2006 show that this move has worked, our figures are now in line with other developed countries. Since 2006 we have taken significant steps to tackle infections.”
Professor Duerden stated that hospital infection rates were now falling.
In November 2007, The Health Protection Agency reported that the rate of C. diff infection could now be levelling out, with the number of new cases down to 13,360, a fall of 7%.
What is Clostridium difficile?
C. diff is one of the ‘normal’ bacterium in the gut of up to 3% of adults and 66% of children. It does not need oxygen to thrive and reproduce and survives well in the large intestine where little oxygen is present. C. diff does not generally affect healthy people because ‘good’ bacteria in the intestine keep it in check.
However, some antibiotics interfere with the healthy balance of bacteria and C. diff can multiply and produce toxins. People with C. diff naturally in their gut cannot spread the bacteria unless it starts to produce toxins. This is why many with the bacteria do not have symptoms.
Who is Most Vulnerable to C. diff infection?
- People previously treated with broad spectrum antibiotics (antibiotics that treat different types of bacteria).
- People staying for a long period in a healthcare setting, e.g. a hospital.
- People aged over 65.
- People with serious underlying medical conditions.
- People with weakened immune systems.
- People who have had numerous enemas or gut surgery.
What is the Treatment for C. diff infection?
- If possible, stop taking antibiotics that cause the infection allowing ‘good’ bacteria to re-grow in the gut.
- In severe cases taking an antibiotic to kill C. diff bacteria, e.g. vancomycin or metromidazole.
- If symptoms recur prescribing probiotic treatments (good bacteria) to encourage natural bacteria to re-grow.
- In serious cases surgery to repair damaged intestines.
How Do You Prevent C. diff Infection?
C. diff is difficult to prevent in healthcare environments but precautions can prevent infection.
If visiting a patient suffering from a stomach upset or diarrhoea:
- Wash hands with soap and water. In addition use alcohol gel if available.
- Do not visit if unwell or recently suffered diarrhoea.
- Do not sit on beds.
- Observe visiting hours and guidelines.
If working in a healthcare setting:
- Wear disposable aprons when caring for anyone with a C. diff infection. When possible patients should have own room and toilet facilities to minimise risk of passing the infection.
- Staff, patients and visitors encouraged to wash hands regularly and thoroughly.
- Use of alcohol gel in addition to soap and water to wash hands.
- Surfaces that may have come into contact with the bacteria to be cleaned thoroughly with disinfectant and water.
The prescription of antibiotics:
- The Department of Health advise Doctors to reduce the amount of broad spectrum antibiotics prescribed to cut the number of people vulnerable to C. diff infection.
Sources:
BBC News (2008)
Office For National Statistics (ONS)
NHS Direct (2008)
