C. difficile Most Common Health Care Associated Infection

Fernanda C. Lessa, M.D., M.P.H. Centers for Disease Control and Prevention Atlanta, GAMedicalResearch.com Interview with:
Fernanda C. Lessa, M.D., M.P.H.
Centers for Disease Control and Prevention
Atlanta, GA

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Lessa: The epidemiology of Clostridium difficile has gone through dramatic changes over the last decade. C. difficile has become the most common cause of healthcare-associated infections in US hospitals and it has been also increasingly reported outside of healthcare settings. As the epidemiology of this pathogen changes, it is important to understand the magnitude and scope of this infection in the United States to help guide priorities for prevention.

Main findings:

1)      C. difficile was responsible for almost half million infections and associated with 29,000 deaths in 2011 in the United States

2)      Among the patients who developed C. difficile, 83,000 had recurrent infections

3)      C. difficile incidence was higher among females, whites, and persons 65 years of age or older

4)       Approximately 345,400 infections occurred outside of the hospital indicating that C. difficile prevention should go beyond hospital settings.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Lessa:

Clinicians can:

  • Prescribe and use antibiotics carefully. Once culture results are available, check whether the prescribed antibiotics are correct and necessary.
  • Order a C. difficile test if the patient has had three or more unformed stools within 24 hours.
  • Isolate patients with C. difficile immediately.
  • Wear gloves and gowns when treating patients with C. difficile, even during short visits. Hand sanitizer does not kill C. difficile, and although hand washing works better, it still may not be sufficient alone, thus the importance of gloves.
  • Clean room surfaces thoroughly on a daily basis while treating a patient with C. difficile and upon patient discharge or transfer. Supplement cleaning as needed with use of bleach or another EPA-approved, spore-killing disinfectant.
  • When a patient transfers, notify the new facility if the patient has a C. difficile infection.

Patients can:

  • Take antibiotics only as prescribed by their doctor and complete the prescribed course of treatment. Antibiotics can be lifesaving medicines.
  • Tell their doctor if they have been on antibiotics and get diarrhea within a few months.
  • Wash their hands before eating and after using the bathroom.
  • Try to use a separate bathroom if they have diarrhea, or be sure the bathroom is cleaned well if someone with diarrhea has used it.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Lessa: It will be important to monitor the burden of C. difficile infection overtime in order to ensure that progress towards C. difficile prevention are being made

Citation:

Burden of Clostridium difficile Infection in the United States

Fernanda C. Lessa, M.D., M.P.H., Yi Mu, Ph.D., Wendy M. Bamberg, M.D., Zintars G. Beldavs, M.S., Ghinwa K. Dumyati, M.D., John R. Dunn, D.V.M., Ph.D., Monica M. Farley, M.D., Stacy M. Holzbauer, D.V.M., M.P.H., James I. Meek, M.P.H., Erin C. Phipps, D.V.M., M.P.H., Lucy E. Wilson, M.D., Lisa G. Winston, M.D., Jessica A. Cohen, M.P.H., Brandi M. Limbago, Ph.D., Scott K. Fridkin, M.D., Dale N. Gerding, M.D., and L. Clifford McDonald, M.D.

N Engl J Med 2015; 372:825-834
February 26, 2015
DOI: 10.1056/NEJMoa1408913

MedicalResearch.com Interview with: & Fernanda C. Lessa, M.D., M.P.H (2015). C. difficile Most Common Health Care Associated Infection