Dangerous bacteria infecting and killing thousands at hospitals and other healthcare settings:
Community-acquired infection expert to discuss how to prevent, treat C. difficile
CHICAGO, Dec. 4, 2008 - Painful abdominal cramping and severe diarrhea, no appetite, high fever and nausea – most would think of these symptoms as reasons to go to the hospital – not a result of having been in one.
However, these are the agonizing symptoms of Clostridium Difficile (C. difficile), a national health epidemic that experts, including American Society for Clinical Pathology (ASCP) member and lecturer Lance Peterson, MD, FASCP, have traced to the overuse of antibiotics, improper hand-washing and other substandard sanitation practices in hospitals.
Peterson will answer questions on Dec. 8 about the infection and the wave of related illness and fatalities during an ASCP teleseminar, “Clostridium Difficile Infection (CDI): The Changing Disease and Evolving Laboratory Diagnostics.” The session is from 1 to 2:15 p.m. CST.
MedPage Today recently reported that the C. difficile epidemic has reached all 50 states and is likely to get worse before it gets better. In 2005 alone, according to a May 2008 USA Today article, C. difficile played a role in nearly 300,000 hospitalizations and nursing homes. A U.S. Centers for Disease Control and Prevention report shows that about 20,000 deaths were related to C. difficile between 1999 and 2004. It’s not just affecting the United States: Britain-based The Guardian reported in September that C. difficile claimed some 26,000 lives there between 1997 and 2007.
C. difficile normally resides in the body, but with the overuse of antibiotics, it builds resistance and becomes overgrown, causing bloating, constipation and severe diarrhea. It is transmitted through spores in feces that are able to survive for months on most surfaces. Similar to the methicillin-resistant Staphylococcus aureus (MRSA) bacteria, C.difficile can be life-threatening and is considered a “superbug” that mutates to build resistance to antibiotics and is highly transmittable in healthcare settings.
Shirley Steele of Arlington, Va. found herself with a 105-degree temperature, weak, nauseous and with extreme diarrhea. Although Steele has spent the last 20 years as a medical technologist, she did not link the antibiotics that her dentist had given her for a pesky tooth infection to her symptoms.
“My dentist gave me two doses of an antibiotic and when the infection still didn’t clear up, he sent me to an oral surgeon who also gave me antibiotics to make sure the infection cleared,” Steele recounted. “I had three doses of antibiotics in the space of two weeks. I didn’t think to tell the oral surgeon about my previous antibiotics and that was my downfall.”
It was when her daughter, a nurse in Florida, who finally told her she had symptoms of C. difficile.
“She told me ‘Mom, people die from that,’” Steele said. “I was scared.”
After weeks of symptoms, treatments with oral Vancomycin finally made her temperature go down and knocked out the other symptoms too.
“I learned that patients have to be involved in their treatment and share all they can when going from one doctor to the next,” she said. “If you’re in the hospital make sure things are cleaned and bleached. Ask questions and be proactive in your own health care.”
Peterson, an expert in healthcare-associated infections and the director of microbiology and infectious diseases research at the Evanston (Ill.) NorthShore University HealthSystem, believes that it will probably get worse before it gets better.
His expertise was sought during the MRSA epidemic in recent years, as he developed one of the first programs in the country to screen all patients for MRSA at his hospital.
“The critical issue is that clinicians need to be aware of the presentation of C. difficile so that they can do a better job of selecting who to test,” Peterson said. Those in the laboratory need better understanding of how the various tests perform so they are best used for detecting the presence of C. difficile in a patient’s stool.”
During the Dec. 8 session, he will discuss current treatments, including the “fecal implant” (highlighted on a recent episode of ABC’s “Grey’s Anatomy”) and its implications, as well as what patients can do to protect themselves when going to the hospital, who it effects, how it is treated, and new technology available to rapidly detect C. difficile toxins in the body.
To join the session or schedule an interview with Peterson, contact Gelasia Croom at gelasia.croom@ascp.org or 312.541.4754.