Clostridium Difficile
The number of deaths related to the hospital-acquired infection, Clostridium Difficile (C. difficile), is on the increase and in the UK it has outstripped the number of deaths attributed to MRSA.
What is C. difficile?
C. difficile is the major cause of diarrhoea following antibiotic therapy. It can also cause no symptoms at all, however, in some cases it causes severe inflammation of the bowel which can be life threatening.
Most infections occur in hospitals (including community hospitals) and nursing homes, although it can also occur in the community. Most of those affected are elderly patients with underlying illnesses. While C. difficile colonises the large intestine, not all patients who are colonised will develop diarrhoea.
C. difficile is a bacterium found in the gut of up to 3% of healthy adults and 66% of infants, where it rarely causes problems. However, it can cause problems when its growth goes unchecked. For example, treatment with certain antibiotics can disturb the balance of "normal" bacteria in the gut, allowing C. difficile to thrive.
Transmission
Although some people are healthy carriers of C. difficile, in most cases the disease develops after cross infection from another patient, either through direct patient to patient contact, via healthcare workers, or via a contaminated environment. The bug forms spores which can contaminate the patient's general environment. The spores can survive for a long time and be a source of infection for other patients, especially if they have also received antibiotic therapy.
C. difficile is not a superbug and is relatively easy to treat. However, recovery is sometimes slow as those who are affected by C. difficile are generally elderly patients, those with weakened immune systems and those who have had repeated enemas or gut surgery.
C. difficile 027
A new strain of C. difficile was identified in 1999 - C. difficile 027. Type 027 appears to be a more virulent strain as it produces much more of the toxins than most other types due to a deletion in the gene that normally restricts toxin production. It causes a greater proportion of severe disease and appears to have a higher mortality. It also seems to be very capable of spreading easily between patients. This strain has increased antimicrobial resistant to some antibiotics and administration of these antibiotics has emerged as an important risk factor for C.difficile associated diarrhoea in a recent endemic in Quebec, Canada.
Prevention and Control
There are three important components to the prevention and control of the C. difficile disease:
- Prudent antibiotic prescribing to reduce the use of broad spectrum antibiotics
- Isolation of patients with C. difficile diarrhoea, and good infection control practices
- Handwashing with soap and water
- Healthcare workers should wear gloves and aprons when dealing with patients
- Enhanced environmental cleaning of patient care areas. The use of chlorine containing disinfectant is generally recommended
Making a claim
For further information on C. difficile and other hospital acquired infections, please contact Malcomson Law by calling 01 8744422 or by filling out an Online Enquiry Form. A solicitor who specialises in this area will contact you to advise you of your legal rights and entitlements.