People receiving medical care can catch serious infections called healthcare associated infections (HAIs). One type of HAI – caused by the bacteria Clostridium difficile – was estimated to cause almost half a million infections in the United States in 2015, and 15,000 deaths within 30 days of the initial diagnosis. Clostridium difficile (C. diff) is a common bacterium found in the human intestine, but it becomes a serious gastrointestinal infection when individuals have been exposed to antibiotic therapy; the antibiotics kill off the good gut bacteria, leaving C. diff to flourish. There are significant risk factors associated with getting C. diff: patients who are immunosuppressed, patients who have been on antibiotic therapy, and the elderly population are at an increased risk, though anyone can get a C. diff infection. Symptoms of a C. diff infection are diarrhea, abdominal pain, fever, and fatigue. These symptoms can advance to a complication of a severe inflammation of the colon; pseudomembranous colitis, which can also lead to further complications of toxic megacolon (a severe form of colonic distension). The mode of transmission of C. diff can be either direct (person to person) or indirect (transmission through a contaminated object). It can also be healthcare associated or community acquired. C. diff spores can be transmitted from staff, visitors, and patients by hands or other contaminated surfaces; additionally altered normal intestinal flora caused by antibiotic therapy allows growth of C. diff in the colon. Coming in contact with contaminated surfaces, devices, or material with C. diff spores can easily be transferred to individuals by hands that have touched a contaminated surface or item. Some examples of surfaces, devices, and materials that could be contaminated with C. diff spores in healthcare settings and community/outpatient settings are commodes, bath tubs, showers, hand rails, bed rails, counter tops, door handles, drawer handles, light switches, clothing, medical equipment, blood pressure cuffs, and walking aides.
It is important to use an EPA Registered antimicrobial effective against C. diff to clean and disinfect surfaces, devices, and materials to prevent the spread of C. diff. Also, please keep in mind that alcohol based hand sanitizer is ineffective against C. diff, so hand washing with soap and water is a must when coming into contact with someone who has or potentially has C. diff and their environment. A significant factor contributing to the seriousness of this infection is inappropriate antibiotic treatments (for example, antibiotics used for a viral infection, or antibiotics that aren’t effective against a particular bacteria). Antibiotics cause a disruption in the normal intestinal flora which leads to an overgrowth of C. diff bacteria in the colon. The leading antibiotics known to disrupt the normal intestinal flora include, but are not limited to Ampicillin, Amoxicillin, Cephalosporins, Clindamycin, and the broad spectrum antibiotics. To do your part in preventing the spread of C. diff, you should take antibiotics only as prescribed by your doctor and complete the full course of treatment (don’t stop taking them when you feel better), tell your doctor if you’ve been on antibiotics and you get diarrhea within a few months, wash your hands before eating and after using the restroom, and try to use a separate bathroom from those who have had diarrhea or be sure the bathroom is cleaned well if someone with diarrhea has used it. Preventing infections and improving antibiotic prescribing could save 37,000 lives from drug-resistant infections, and an estimated $3,800,000,000 in medical costs over the course of 5 years.
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AuthorOPHIE records and analyzes data from disease investigations, identifies risk factors, and provides education on disease prevention in Nevada. Archives
November 2018
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