C. Diff Infection Rates Rising Among U.S. Health Care Inpatients

The rate of infection of Clostridium difficile—a life-threatening bacterium that causes diarrhea and more serious intestinal conditions—has been increasing among U.S. health care inpatients, according to a survey published in the  American Journal of Infection Control . The survey concludes that Clostridium difficile (C. diff) is sickening more patients than previously estimate.  The study,"The National Point Prevalence of Clostridium difficile in U.S. Healthcare Facility Inpatients, 2008," indicates that 13 out of every 1,000 inpatients were either infected or colonized with C. diff during their time in a health care setting. The rate is 6.5 to 20 times greater than previous incidence estimates, according to the survey. Based on this rate, it is estimated that there are at least 7,178 inpatients on any one given day in American health care institutions with an associated cost of $17.6 to $51.5 million. Of the clinicians who participated in the survey, 82 percent reported that C. diff infection rates had not decreased over the past three years.  "This study shows that C. difficile infection is an escalating issue in our nation's health care facilities," said William Jarvis, MD, principal investigator of the study and president and co-founder of Jason and Jarvis Associates, a private consulting firm in health care epidemiology. "Clearly, preventing the development and transmission of C. diff should be a top priority for every health care institution." The survey is the largest and most comprehensive of its kind, and presents a one-day snapshot in time of the prevalence of C. difficile infection in American hospitals.  More than 12,000 members of the Association for Professionals in Infection Control and Epidemiology (APIC) collected data on their C. diff patients on one day between May and August 2008.  Survey results were collected from 12.5 percent of all medical facilities in the U.S. that care for virtually every type of patient, including those at acute care, cancer, cardiac, children's, long-term care and rehabilitation hospitals. A total of 1,443 patients were identified with C. diff from among the 648 participating hospitals. Clostridium difficile is most frequently associated with previous antibiotic use and is most commonly contracted by the elderly and those with recent exposure to hospitals, nursing homes and other health care institutions. It is transmitted by hand contact with items contaminated by feces. In the last five years, a more virulent and antibiotic-resistant strain has developed which has been associated with more serious disease, treatment failures and deaths. To reduce the risk of transmission, APIC has published a Guide to the Elimination of Clostridium difficile in Healthcare Settings . The guide's recommendations include a risk assessment to identify high-risk areas for C. diff within the institution; surveillance program to outline activities and procedures to provide early identification of C. diff cases; adherence to hand hygiene guidelines from the Centers for Disease Control and Prevention; use of contact precautions (e.g., gloves, gowns and separating C. diff patients from other patients); environmental and equipment cleaning and decontamination, especially items that are close to patients such as bed rails and bedside equipment; and antimicrobial stewardship programs with focus on restriction of antibiotics associated with C. diff and unnecessary antimicrobial use. Source:   Association for Professionals in Infection Control and Epidemiology  

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C. Diff Infection Rates Rising Among U.S. Health Care Inpatients

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