C. diff Infections: Worse Than We Thought

Aug 21, 2012, 1:20 PM, Posted by

Medical professionals check a patient during admittance procedure.

Infections caused by the dangerous microbe Clostridium difficile, or C. diff, are much more prevalent in hospitals and health care facilities than previously reported, according to an investigative front page story in USA Today. This bug is most often seen in hospitals, nursing homes, and other medical facilities. It causes severe diarrhea and intestinal problems that can worsen and even be fatal. The story cites a scientist from the Centers for Disease Control and Prevention who says annual fatalities may be as high as 30,000 per year, more than twice as high as some recent estimates.

The article accurately points to many reasons for this problem. Many hospital infection control programs aren’t stringent enough and C. diff reporting rates are poor. Hospitals need to be more prudent in their antibiotic use. C. diff thrives when healthy bacteria usually present in the intestines are wiped out by certain antibiotics patients take. In the absence of these healthy bacteria, C. diff can take over.

The problem is exacerbated by the overuse of antibiotics, often in place of effective infection control. All health care providers – in health care facilities and in the community –  must use antibiotics prudently in order to slow the rate at which these powerful drugs become ineffective against C. diff, MRSA, and other dangerous bacteria.

We know that the evolutionary battle with microbes is, by nature, a losing one. Bacteria will continue to become resistant faster than our efforts to stop them. So as current antibiotics become ineffective, we need new drugs at the ready. However, efforts to bring new drugs to market need to be coupled with plans to conserve their use to maintain their effectiveness.

In order to get to the root of a problem like C. diff, we need comprehensive solutions that address not just antibiotic overuse but also infection prevention (such as vaccination) and infection control.

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Ramanan Laxminarayan is director of Extending the Cure, a research effort that examines policy solutions to address the growing problem of antibiotic resistance. The project is based at the Center for Disease Dynamics, Economics & Policy (CDDEP) in Washington, D.C., and is funded in part by the Pioneer Portfolio of the Robert Wood Johnson Foundation.

This commentary originally appeared on the RWJF Pioneering Ideas blog.