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C. diff on the Rise Outside the Hospital

Risk Factors for C. diff Include Antibiotic Use and Being Over Age 65

Patient-to-Doctor Spread of C. diff

Researchers at the meeting reported that patients who have recently recovered from community-acquired C. diff may spread it to doctors and nurses who see them for follow-up visits.

Forty-five percent of gloves worn by health care workers who touched the skin of 35 such patients tested positive for C. diff spores, says Lucy Jury, RN, MSN, a nurse researcher at Louis Stokes Department of Veterans Affairs Medical Center in Cleveland.

In a separate study, Jury and colleagues found that two simple questions -- asking whether a patient has had a C. diff infection and/or has been on broad-spectrum antibiotics within the past three months -- can identify the majority of so-called carriers of C. diff. Carriers don't have symptoms but are shedding spores and can spread the disease.

In the study of 120 nursing patients followed for five months, the two questions correctly identified about three-fourths of carriers.

While nearly one-fourth of cases were missed, "it's the best we have," Jury tells WebMD.

C. diff Recurrence

A mid-stage, industry-funded study showed that a novel antibiotic known as CB-183,315 appears safe and more effective than the drug vancomycin (Vancocin) at preventing recurrences of C. diff infections.

Vancomycin and metronidazole (Flagyl) wipe out C. diff in 80% to 90% of patients, says researcher Thomas Louie, MD, an infectious diseases specialist at the University of Calgary, in Canada. But after seemingly successful initial treatment, symptoms come back in 25% or more of patients, he tells WebMD.

In the new study, vancomycin was associated with a 35% recurrence. Low- and high-dose CB-183,315 had recurrence rates of 28% and 17%, respectively.

"That's the big bear we’re all trying to tackle -- the recurrence rate," says James McKinnell, MD, of Harbor-University of California, Los Angeles Medical Center. He was not involved with the work.

Larger, longer phase III studies are needed to confirm long-term safety and effectiveness.

Preventing C. diff

So what should you do to avoid C. diff? Two simple steps will go a long way toward keeping you infection-free, experts say:

  • Don't demand antibiotics if your doctor says you don't need them.
  • Wash your hands thoroughly and frequently.

These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.


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