THE CMG VOICE

Clostridium Difficile Infections are Rising in the U.S.

The Centers for Disease Control (CDC) recently issued a study that showed that almost 500,000 U.S. residents suffered Clostridium difficile infections in the single year of 2011. This infection, commonly called C. difficile or C-diff, can cause inflammation of the colon, severe bloating, and diarrhea, sometimes leading to death. In most cases, the infection occurs during hospitalizations, and is now the most common hospital-based pathogen.

The CDC report points out that the infection can cause $4.8 billion each year in healthcare costs in acute-care facilities. Relapses of C-diff infections occur in up to 20% of cases. C-diff infections are a growing problem in health care facilities, killing approximately 29,000 people in the United States in 2011.

Ironically, taking antibiotics for other infections is a major risk factor for C-diff infections. The antibiotics kill normal gut flora, which are then replaced by the C-diff organisms. The disturbance of normal healthy bacteria provides C. difficile an opportunity to overrun the intestinal microbiome. Often, mild cases of C-diff can be treated by stopping the offending antibiotics. More serious cases require targeted antibiotic treatment.

The CDC report emphasizes that moderating and controlling antibiotic prescribing is key to minimizing the C-diff spread. It advocates developing antibiotic prescribing programs called “antibiotic stewardship” programs. The growth in C-diff infections and deaths is another reason why physicians are becoming more reluctant to freely prescribe antibiotics, preferring to use them only when absolutely necessary. The reason used to be concern over the development of “super bugs,” such as MRSA. Now, an additional reason is to avoid C-diff infections.