C. Diff is taking it to the streets

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The nasty bacterial infection, Clostridium difficile (C. diff), is making its way out of the hospital and into the community. Hospital patients have long been at risk of acquiring this infection, but a new study presented at the Digestive Disease Week s annual medical conference indicates that now children who aren t hospitalized are also being infected at increasingly high rates.

The study, conducted by a Mayo Clinic researcher and colleagues, analyzed medical records from a Minnesota community. They found that, between 2004 and 2009, the rate of C. diff infections among children was 12-times higher than the rate between 1991 and 1997. And, most surprisingly, 75 percent of these kids acquired the infection outside of the hospital. Most of the infected kids were taking antibiotics, which is a known risk factor for developing C. diff infection, since these drugs wipe out the normal bacteria in the GI tract that would otherwise compete with C. diff. But the jump in infections outside hospital environments is disconcerting.

The researchers note that this new study is in accord with one they had previously published, which found that approximately 40 percent of C. diff infections originate outside of hospitals. According to the CDC, there are over 300,000 C. diff cases in the U.S. every year, which lead to around 14,000 deaths. The researchers advise that, in order to reduce the toll of C. diff, doctors should be cautious about prescribing antibiotics only when patients truly need them and should try to use narrow-spectrum antibiotics that will kill fewer beneficial bacteria. For the average person, the most important step in C. diff prevention is hand-washing with soap and water, because alcohol-based hand sanitizers won t kill this bug.

When I was practicing as a physician, says ACSH's Dr. Gilbert Ross, we only very rarely saw C. diff infections. When we did, it was usually in patients who were very ill, with debilitating immune system compromise, and who were on very powerful wide-spectrum antibiotics. Now that this devastating infection has become more widespread, measures to prevent doctors from excessively prescribing wide-spectrum antibiotics are even more important.