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CDC finds C. difficile cases becoming more pervasive

Tuesday March 6, 2012
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Infection from Clostridium difficile is a patient safety concern in all types of medical facilities, not only hospitals as traditionally thought, according to a report from the Centers for Disease Control and Prevention.

The report found that while many healthcare-associated infections, such as bloodstream infections, declined during the past decade, C. difficile infection rates and deaths climbed to historic highs.

C. difficile is linked to about 14,000 U.S. deaths every year, according to the report. Those most at risk are people who take antibiotics and also receive care in any medical setting. Almost half of infections occur in people younger than 65, but more than 90% of deaths occur in people 65 and older.

Previously released estimates based on billing data show the number of U.S. hospital stays related to C. difficile remains at historically high levels of about 337,000 annually, adding at least $1 billion in extra costs to the healthcare system. However, the report in the March edition of Vital Signs shows these hospital estimates may only represent one part of C. difficile's overall impact.

According to the report, 94% of C. difficile infections are related to medical care. About 25% of infections first show symptoms in hospital patients, while 75% first show in nursing home patients or in people recently cared for in doctor's offices and clinics.

Although the proportion of infection onset is lower in hospitals, these facilities remain at the core of prevention efforts since many patients with C. difficile infections are transferred to hospitals for care, raising risk of spread within the facility. The report found that half of C. difficile infections diagnosed at hospitals were present on admission, usually after the patient received care in other facilities. The other half were related to care given in the hospital where the infection was diagnosed.

The report highlights three programs showing early success in reducing C. difficile infection rates in hospitals: 71 hospitals in Illinois, Massachusetts and New York decreased C. difficile infections by 20% in less than two years by following infection control recommendations.

Patients incur C. difficile infections most often within a few months of taking antibiotics and also receiving medical care. Antibiotics stop infections, but they also destroy the body's good bacteria for several months. During this time, patients can get sick from C. difficile picked up from contaminated surfaces or that spreads from a healthcare provider's hands. Infection risk generally increases with age. Identifying C. difficile infection early and stopping its spread to other people can save lives.

Patients can help stop C. difficile through steps such as taking antibiotics only as prescribed, telling a healthcare provider if they have been on antibiotics and get diarrhea within a few months, washing their hands after using the bathroom, and trying to use a separate bathroom if they have diarrhea or ensuring the bathroom is cleaned well if someone with diarrhea has used it.

To read the Vital Signs report, visit http://1.usa.gov/haf375.

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