Not Just a Hospital Problem: Deadly C. Diff in Doctor's Offices, Clinics
March 6, 2012 -- America's deadly C. diff epidemic is spreading not just in hospitals, but in doctor's offices, clinics, and other health care facilities, a CDC study finds.
C. diff -- short for Clostridium difficile -- are spore-forming bacteria that cause diarrhea. Severe cases can result in a life-threatening condition called toxic megacolon. There's an ongoing epidemic with a particularly nasty, especially toxic C. diff strain.
C. diff kills about 14,000 Americans each year. Half of infections are in people younger than age 65. But 90% of deaths are in people 65 and older.
Cases have tripled over the last decade. Why?
"Traditionally, C. diff infections were thought to be mostly a problem for hospitals. But today's report shows that these infections are a patient safety concern in nursing homes and outpatient care settings as well," Ileana Arias, PhD, CDC principal deputy director, said at a news conference.
There's been a lot of worry about C. diff spreading in the community. But the CDC study finds that nearly all C. diff infections -- 94% -- are linked to medical care. About 75% of C. diff infections first show up in people recently cared for in doctor's offices, clinics, or nursing homes.
How C. Diff Spreads
Here's how it works. In a typical scenario laid out by the CDC:
You go to the doctor's office and get a prescription for an antibiotic.
A month later, you break your leg and go to the hospital.
A health care worker forgets to wear gloves while caring for a C. diff patient in another room. You get a C. diff infection.
Two days later, you go to a rehab facility, where you come down with diarrhea. You are not tested for C. diff. Your nurse doesn't know you are infected and doesn't wear gloves while treating you.
Another patient gets infected.
You finally get diagnosed with C. diff and properly treated -- ironically, with antibiotics.
McDonald says that this constant interplay between different kinds of health care facilities keeps C. diff in circulation. Half of cases diagnosed in hospitals are in patients already infected when admitted to the hospital.
"That means hospitals are partly at the mercy of surrounding facilities," McDonald says. "Because patients often transfer back and forth, an infection in one place can easily become a problem in another. This points to strict need for prevention across all facilities." [...]
The article also advises what patients and care givers can do to stop C. diff.