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C. diff Infections in Hospitals Are Leveling Off

Researchers Say Careful Use of Antibiotics and Better Sanitary Methods May Be Curbing C. diff Infections
WebMD Health News
Reviewed by Laura J. Martin, MD

Oct. 26, 2011 (Honolulu) -- After explosive growth in North American hospitals at the beginning of the millennium, the number of new infections with the bacterium Clostridium difficile (C. diff) appears to have leveled off, a new study shows.

"We find this tremendous growth from 2000 to 2005, but from 2005 to 2009 there is a leveling off," study co-researcher Marya D. Zilberberg, MD, MPH, tells WebMD.

C. diff infection can cause severe diarrhea, most often when a patient takes antibiotics for some other purpose. The antibiotics kill the beneficial bacteria, allowing C. diff to grow out of control. Other antibiotics can be used to kill the C. diff, but the organism is evolving resistance to them.

"We used to have nice tame C. difficile bugs in the hospital," says Zilberberg, who is the CEO of the consulting firm EviMed Research Group in Goshen, Mass.

But in the 1980s and 1990s, hospitals used a lot of antibiotics in a class of drugs called fluorquinolones. Gradually, a strain of C. difficile evolved resistance to these drugs. It also evolved sticky spores that are hard to clean from hospital surfaces, allowing it to spread more easily, Zilberberg says.

"Lo and behold what we had is this new hypervirulent [increase in ability to cause disease] strain," she says. "It's a bug for the 21st century."

Analyzing data on hospital infections maintained by the U.S. Agency for Healthcare Research and Quality, Zilberberg and her colleagues found that the rate of C. diff infections in U.S. hospitals more than doubled from 2000 to 2005. Since then it has more or less held steady. The number of new infections was 328,055 in 2009, the most recent year for which the researchers could obtain data.

They reported their findings at CHEST 2011: the American College of Chest Physicians Annual Meeting.

Treating C. diff

Until recently, there was only one antibiotic, vancomycin, approved by the FDA to treat C. diff. In May, the FDA approved fidaxomicin for this purpose. (Optimer Pharmaceuticals, which makes fidaxomicin, hired Zilberberg and her colleagues to conduct this study.)

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