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CDC warns about 'deadly diarrhea germ'

Consumer Reports News: March 06, 2012 02:38 PM

Some 14,000 Americans die every year from a bacterial infection known as Clostridium difficile, or C. diff. for short, and another 300,000 are hospitalized, according to a report released today from the Centers for Disease Control and Prevention. And unlike other hospital-acquired infections, those numbers are going up instead of down—largely due to the rise of antibiotic-resistant strains of the bacteria.

C. diff. is a particularly nasty bug that can cause severe diarrhea and intestinal bleeding. Those most at risk include people who have been in a hospital or other health-care facility and taken antibiotics in the past three months, especially those over 65.

In the past decade, drug-resistant strains of the bacteria have developed, causing infections to double, hospitalizations to triple, and associated deaths to quadruple. The rise of resistant strains stems from the overuse of antibiotics. About half of the antibiotics that patients take are unnecessary, according to the CDC. And whenever you take an antibiotic, many of the beneficial germs that compete with C. diff. may also be killed, creating a more hospitable environment for drug-resistant strains to infect your gut and reproduce.

The Food and Drug Administration also recently warned that heartburn drugs called proton pump inhibitors (PPIs), such esomeprazole (Nexium) and omeprazole (Prilosec, Prilosec OTC, and generic), might increase the risk of serious C. diff. infections. The FDA is also looking into whether there's a higher incidence of C. diff. infections in people who take another type of heartburn drug called H2 receptor blockers, such as cimetidine (Tagamet OTC and generic), famotidine (Pepcid AC and generic), nizatidine (Axid AR) and generic, and ranitidine (Zantac 75, Zantac 150, and generic).

“C. difficile harms patients just about everywhere medical care is given,” said Thomas R. Frieden, M.D., M.P.H., director of the CDC, in a statement. Almost all of the infections originated in a health-care facility, according to the CDC, but only 25 percent occurred in hospitals. The bulk of the infections first appeared outside of hospitals, most often in nursing homes or even at home after a visit to a doctor’s office or clinic.

Despite the widespread growth of these infections over the last decade, they can be prevented. Hospitals that adhered to strict infection-control recommendations cut C. diff. infections by 20 percent in less than two years, according to the CDC. But these figures suggest that too few health care facilities follow those recommendations carefully.

Bottom line: If you are in the hospital or other health-care facility, ask the staff what steps they’re taking to control C. diff. The bacteria is usually spread by touching, or picked up from contaminated surfaces. Hospitals and other health-care facilities should test for C. diff., and isolate patients that prove positive to prevent its spread. If the bacteria is present in one or more patients, the facility should clean rooms with bleach or another strong, EPA-approved disinfectant. And while all health-care providers should wash their hands, that might not be enough to stop the transfer of C. diff. If your facility has tested positive for the bacteria, expect your providers to don gowns and gloves.

You can help by only taking antibiotics when they are absolutely necessary, telling your doctor if you get diarrhea within a few months of taking antibiotics, and by always washing your hands after using the bathroom, according to the CDC.

Find out how well your hospital does at preventing other deadly types of infections using our Hospital Ratings. And for more on preventing infections, see our reports on deadly bloodstream infections in adult and pediatric ICUs, New York City's least safe hospitals, and our Hospital Survival Guide.

Sources
Making Health Care Safer; Stopping C. difficile Infections [CDC]

Kevin McCarthy


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