Clostridium difficile (C. diff) has surpassed methicillin-resistant staphylococcus aureus (MRSA) as the most common hospital-acquired infection, according to a study presented at the Fifth Decennial International Conference on Healthcare-Associated Infections 2010.
Researchers looked at infections at 28 community hospitals in the Duke Infection Control Outreach Network between January 2008 and December 2009. There were 847 cases of C. diff in that time, compared to 680 cases of MRSA.
This indicates that steps taken to reduce MRSA do not work to reduce C. diff, researchers said.
The increase of C. diff has been linked to use of fluoroquinolones, third-generation cephalosporins, and clindamycin antibiotics, which alter the normal bacteria of the colon and cause over-production of toxins. This may cause diarrhea and colon inflammation, which, in severe cases, may lead to treatment in intensive care, surgical removal of the colon, and possible death.
For several years, the Pennsylvania Medical Society has been educating clinicians and the community about the importance of using antibiotics appropriately.
Physicians should ensure that C. diff cases are treated promptly. Discontinue use of the offending antibiotic and administer oral metronidazole. If treatment fails, consider using vancomycin.
Isolate patients in a room by themselves, use barrier precautions such as gowns, masks, and gloves, and use sporicidal agents to clean the environment.
Another study at Healthcare-Associated Infections 2010 found that cleaning patient rooms daily with germicidal bleach wipes reduced the incidence of the infection from 18.4 to 3.76 per 10,000 patient days.
Make sure anyone in contact with the patient is fastidious about hand washing because the infection can be spread by those who have contact with infected patients or touch surfaces contaminated with spores. Alcohol-based hand sanitizers do not kill C. diff, so washing with soap and water is required.