Clostridium difficile infections are down 36% in Canadian hospitals

Rates of It's hard infections are down 36% in Canadian hospitals, although the NAP1 virulent strain associated with serious illness and death is the most common strain, according to a study published in CMAJ (Journal of the Canadian Medical Association)

Clostridium difficile is the most common infectious cause of diarrhea in hospitalized patients in developed countries, causing serious illness and sometimes death. The elderly and people on antibiotic treatment are the most vulnerable to infection. However, the NAP1 strain of It's hard, which is the most virulent and can be resistant to treatment with antibiotics fluoroquinolones, has emerged in healthy people and in the community, spreading after several epidemics in the early 2000s.

A pan-Canadian team of researchers from the Canadian Nosocomial Infection Surveillance Program reviewed data from 42-53 acute care hospitals over a seven-year period (2009-2015) to understand trends in the NAP1 strain and the prevalence of NOCs. effect of infection on the results. A total of 20,623 cases of hospitalization It's hard it's produced, mainly in hospitals with more than 200 beds. Infection rates fell by 35.8% in Canada in 2015, although the number of younger patients with the disease has increased.

Improvements in infection control measures (improved testing, smarter use of antibiotics, frequent hand washing and more frequent cleaning of facilities) started after outbreaks 10 or 15 years ago may have contributed to lower rates d & # 39; infection.

The large study found an association between NAP1 strain and death in patients aged 18 years and older, undetected by previous monocentric or provincial studies.

"Our results suggest that, as the proportion of isolates of NAP1 strain decreases relative to all circulating strains, both the rate of associated health care It's hard It can be expected that the infection and the number of severe cases will decrease compared to an even hospital where the proportion of circulating NAP1 isolates is higher, "says Dr. Kevin Katz, Hospital North York General, Toronto, Ontario.

The authors recommend continued vigilance to better contain the infection.

"Infection prevention, control, antimicrobial stewardship and environmental clean-up practices should continue to be strengthened at the local level, as these areas have a positive impact on institutional rates of C. difficile infection, with little imports the types of circulating strains.

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More information:
"The evolution of the epidemiology of Clostridium difficile infection in Canadian hospitals during a post-epidemic period (2009-2015)" is published on June 25, 2018. www.cmaj .ca / lookup / doi / 10.1503 / cmaj.180013