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C. diff Epidemic: What You Must Know

Why C. diff Is Spreading, Why It's More Deadly, How to Protect Your Family
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How bad is C. diff? continued...

To date, the NAP1 strain has been reported in 37 U.S. states and in the District of Columbia.

A recent report shows that adult C. diff hospitalizations doubled between 2000 and 2005 to about 300,000 hospitalizations a year. That's more hospitalizations than are seen with MRSA, which sends about 126,000 Americans to the hospital each year.

The CDC's C. diff expert, L. Clifford McDonald, MD, tells WebMD that if you count pediatric C. diff cases and cases in the community that do not enter the hospital, there are probably half a million U.S. cases of C. diff infection each year.

And yes, it is an epidemic: The infection rate is going up by about 10% a year. But the death rate is going up even faster, says Marya Zilberberg, MD, adjunct professor at the University of Massachusetts, Amherst, and president of the EviMed Research Group.

"The disease appears to be more likely to be fatal ... nearly doubling from a 1.2% to a 2.2% case fatality rate," Zilberberg tells WebMD.

During a hospital outbreak in Canada, the one-year mortality rate for C. diff infection was 17%.

"We're seeing increases both regionally and nationally in death certificates listing C. diff infection," McDonald says. "And hospitals are saying the same thing."

There are actually three ongoing C. diff epidemics. One is in hospitals. Another is in the community. And a third is in livestock.

Is C. diff a superbug?

"Superbug" is not a scientific term. The CDC's McDonald prefers to avoid it. The media originally coined the term to refer to germs that, like Superman, became bulletproof: That is, they became impervious to drugs that kill other germs. Dictionaries reserve the "superbug" designation for germs resistant to drugs that used to kill them.

"Superbug" has also been used to describe germs that, like many superheroes, once were normal but become super strong: That is, they became much more virulent than they used to be.

"I think if I were to use the word "superbug" I might use it to connote a particular strain or strains of a pathogen in which there has been a convergence of increased resistance to antibiotics ... and increased virulence," McDonald says.

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