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TORONTO – Rates of Clostridium difficile, an often recurrent bacterial colon infection that causes debilitating diarrhea, have dropped dramatically in Canadian hospitals since 2009, according to a study.
In a study published Monday in the Journal of the Canadian Medical Association, researchers report that hospital-associated C. difficile infections decreased by 36% between 2009 and 2015.
"There are probably a number of interventions that have led to this decrease," said lead author, Dr. Kevin Katz, medical director of infection prevention and control at North York General Hospital. from Toronto.
Improvements in infection control measures, such as improved testing, more judicious use of antibiotics, frequent hand washing and more frequent and intensive hospital cleansing over the last decade have contributed to the decline in infection rates.
While a virulent form of C. difficile known as NAP1 has been found to be the most common strain affecting patients during the seven-year study, the proportion of cases elicited compared to other strains also declined, according to the researchers.
C. difficile is the most common infectious cause of diarrhea in hospitalized patients in developed countries, leading to serious illness and, in some cases, death. Elderly people and people taking antibiotics are the most vulnerable to infection.
Broad-spectrum antibiotics taken for another infection can kill the so-called good bacteria in the gastrointestinal tract, allowing C. difficile to thrive in those exposed to the stink bug.
C. difficile bacteria produce a toxin that causes inflammation of the colon. The microbe also creates spores that are difficult to eradicate, which can contaminate surfaces in hospital rooms and quickly spread the infection.
Doctors treat C. difficile with more targeted antibiotics, but the bacteria have developed resistance to some of them, often making the disease more difficult to overcome.
NAP1, which is resistant to fluoroquinolone antibiotics, has been responsible for several outbreaks of nosocomial infections over the years, including an epidemic in Quebec that began in 2002. Over the next few years, thousands of patients have developed the disease and at least.
"What's special about NAP1 … is its ability to produce many more toxins," said Katz, noting that spores produced by the strain are much harder to kill by cleaning than "regular germs." ".
To conduct the study, researchers from the Canadian Nosocomial Infection Surveillance Program examined data from acute care hospitals across the country between 2009 and 2015. The nosocomial means acquired during hospitalization.
A total of 20,623 cases of hospital-acquired C. difficile occurred during the network study period, mainly in hospitals with more than 200 beds. During this seven-year period, 158 deaths were attributed to infection, mostly among the elderly.
Dr. Christine Lee, infectious disease physician and medical microbiologist at St. Joseph's Hospital in Hamilton, was not surprised to see the national decline in the number of C. difficile infections, which is Is produced at his hospital and in other regions of the region.
"I think it's thanks to a concerted effort between infection prevention in every hospital and the hypervigilance of health care providers," said Lee, who did not participate in the survey. # 39; study.
"When people work together in a concerted effort, it makes a positive difference."
Lee said that C. difficile not only causes symptoms like severe diarrhea, but infection often returns to patients, despite the treatment.
"It leaves them in a much more debilitating state, it makes them more anxious and socially isolated," she said, noting that concerned people are worried about the reoccurrence of the infection and the potential transmission to others.
"I had women who were asked not to come and see their grandchildren," Lee said. "It's heartbreaking to hear."
Katz said the 36% drop in infection rates in the country reflected a major breakthrough in patient safety.
"To have such a remarkable fall on such a small number of years is excellent news".
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