Infection once found only in hospitals affecting healthy people.
Pastor Dale Morgan
*Infection once found only in hospitals affecting healthy people.*
Updated 10/16/2006 11:31 PM ET
By Anita Manning, USA TODAY
C. DIFFICILE SPREADS
Clostridium difficile bacteria cause diarrhea, usually in hospitalized
patients on antibiotics, but the organism is becoming more widespread.
Studies presented at the Infectious Diseases Society of America meeting,
which ended Sunday, found:
• Nearly one-fifth of people with C. difficile infections picked it up
outside hospitals. Many had no history of antibiotic use.
• The infection is causing severe illnesses in healthy people, including
pregnant women.
An ugly bug that causes diarrhea and colitis is being found more often
and in different settings than previously known, posing new challenges
for doctors, researchers report.
Scientists in Toronto at a meeting of the Infectious Diseases Society of
America, which ended Sunday, presented studies on Clostridium difficile,
an intestinal infection that generally becomes a problem in people who
are hospitalized and on antibiotics. New data suggest it is now
infecting healthy people.
• Nearly one in five people with C. difficile-associated disease, known
as CDAD, acquired it before hospital admission in a study of six
hospitals in 2005 by researchers in North Carolina and at the Centers
for Disease Control and Prevention. A second study at four of the
hospitals found that 59% of cases had no recent antibiotic exposure, but
antibiotic use remains "the most important modifiable risk factor," says
Preeta Kutty, CDC epidemic intelligence service officer.
• Researchers in Philadelphia reported that six healthy women were
treated for serious C. difficile infections this year. Three were
pregnant, one had recently given birth and two had undergone
hysterectomies. Doctors "should have heightened awareness for CDAD in
this population," the researchers concluded.
• The first line of treatment for CDAD is metronidazole, but researchers
at the University of Illinois report that in a study of 150 patients,
cure rates were higher and there were fewer relapses with vancomycin
treatment. The difference was seen most clearly in the 69 severe CDAD cases.
"C. difficile-associated disease is not just diarrhea," says Clifford
McDonald, an expert on the disease and co-author of the CDC study. It
can cause severe illnesses including colitis, perforation of the colon
and bloodstream infections, and it can cause death, he says.
A virulent new strain has caused deadly hospital outbreaks in the USA
and Canada since 2000, McDonald says. "Historically, 1% to 2% of people
with C. diff will die," he says. "With this new epidemic strain, more
like 7% have died in outbreaks, so it's a more serious disease."
It's not clear why so many cases are being found outside hospitals,
McDonald says, but the community strains appear to be less severe than
those found in hospitals.
Posted 10/15/2006 11:28 PM ET