Petri dish containing C. Diff (Photo Credit: Vermont Department of Health)
National Initiative to Prevent C diff Infection
As more Americans are living longer today, clinicians are treating more age related illnesses than ever before. In particular, the suseptibility of Clostridium difficile infection (C diff) in older Americans. A recent CDC study reveals infections among patients in hospitals and nursing homes indicates in every setting that the risks of infection and death increase with age. C diff caused nearly half a million infections among US patients in a single year and almost 29,000 died within 30 days of diagnosis.
The study also revealed two thirds of every HAI C diff infection occur in patients 65 and older, and 80% of those result in death. Of those deaths, one out of nine occur within 30 days of initial diagnosis.
Inadequate infection control and disinfection practice has contributed to the rise in C diff infection, not only within the healthcare facility but also during transportation of infected patients from facility to facility. Clostridium difficile bacteria can live for long periods of time on devices and equipment surfaces like gurneys, tables, and toilets. These and other surfaces where patients may come in contact with the bacteria should be thoroughly cleaned on a daily basis while treating a patient with C diff and then upon discharge or transfer of the patient.
C. difficile infections are at an all-time high.
C. difficile infections are linked to 14,000 deaths in the US each year.
Deaths related to C. difficile increased 400% between 2000 and 2007, due in part to a stronger germ strain.
Most C. difficile infections are connected with receiving medical care.
Almost half of infections occur in people younger than 65, but more than 90% of deaths occur in people 65 and older.
Infection risk generally increases with age; children are at lower risk.
About 25% of C. difficile infections first show symptoms in hospital patients; 75% first show in nursing home patients or in people recently cared for in doctors' offices and clinics.
C. difficile germs move with patients from one health care facility to another, infecting other patients.
Half of all hospital patients with C. difficile infections have the infection when admitted and may spread it within the facility.
The most dangerous source of spread to others is patients with diarrhea.
Unnecessary antibiotic use in patients at one facility may increase the spread of C. difficile in another facility when patients transfer.
When a patient transfers, health care providers are not always told that the patient has or recently had a C. difficile infection, so they may not take the right actions to prevent spread.
C. difficile infections can be prevented.
Early results from hospital prevention projects show 20% fewer C. difficile infections in less than 2 years with infection prevention and control measures.
England decreased C. difficile infection rates in hospitals by more than half in 3 years by using infection control recommendations and more careful antibiotic use.
For Clinicians: 6 Steps to Prevention
1. Prescribe and use antibiotics carefully. About 50% of all antibiotics given are not needed, unnecessarily raising the risk of C. difficile infections.
2. Test for C. difficile when patients have diarrhea while on antibiotics or within several months of taking them.
3. Isolate patients with C. difficile immediately.
4. Wear gloves and gowns when treating patients with C. difficile, even during short visits. Hand sanitizer does not kill C. difficile, and hand washing may not be sufficient.
5. Clean room surfaces with bleach or another EPA-approved, spore-killing disinfectant after a patient with C. difficile has been treated there.
6. When a patient transfers, notify the new facility if the patient has a C. difficile infection.