Dying from C diff: Who Is Most Vulnerable?

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 A new study published in the New England Journal of Medicine describes the burden of Clostridium difficile infection (C diff) in the United States. The study found that C diff caused nearly a million infections among US patients in a single year. Approximately 29,000 patients died within 30 days of the initial diagnosis.

Older Americans are especially vulnerable to this diarrheal infection. Two out of every three healthcare associated C diff infections occur in patients aged 65 years or older. More than 80% of the deaths associated with C diff infection occurred among those aged 65 years or older, and one out of every nine older adults with a healthcare-associated C diff infection died within 30 days of diagnosis, according to the study.

Unnecessary antibiotic use and poor infection control practices may increase the spread of C diff within a healthcare facility and from facility to facility when infected patients transfer. More than 100,000 C diff infections develop among residents of US nursing homes each year, making C diff infections among the most serious healthcare complications that affect the nursing home population.

Healthcare providers can take several steps to prevent C diff infections and reduce the spread of infection.

  • If the patient has had three or more unformed stools within 24 hours, order a C diff test considering that fact that some tests, such as nucleic acid amplification tests, (NAAT), are much more sensitive in detecting the infection than others.
  • Institute isolation precautions immediately for patients with C diff, and wear gloves and gowns when caring for these patients, even during short periods of time.
  • Visitors and healthcare workers should wash their hands with soap and water after visiting or caring for patients with C diff infections.
  • C diff can live for long periods of time on the surfaces of devices and equipment, such as toilets and bedside tables. Room surfaces should be cleaned thoroughly on a daily basis while treating a patient with C diff and upon patient discharge or transfer. To kill C diff, bleach or another Environmental Protection Agency-approved disinfectant active against spores is necessary.
  • When a patient transfers, especially between hospitals and nursing home, notify the new facility if the patient has a C diff infection, so they may take appropriate actions to prevent the spread of infection.
  • Clinicians must prescribe antibiotics carefully. Obtain cultures when an infection is suspected.

Preventing all healthcare associated infections is critical, and implementing strategies to prevent C diff will also improve measures to prevent the spread of other infections among your patients.



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