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C. Diff on the Rise: Is Your Doctor to Blame?

Not Just a Hospital Problem: Deadly C. Diff in Doctor's Offices, Clinics

How C. Diff Spreads

Here's how it works. In a typical scenario laid out by the CDC:

  • You go to the doctor's office and get a prescription for an antibiotic.
  • A month later, you break your leg and go to the hospital.
  • A health care worker forgets to wear gloves while caring for a C. diff patient in another room. You get a C. diff infection.
  • Two days later, you go to a rehab facility, where you come down with diarrhea. You are not tested for C. diff. Your nurse doesn't know you are infected and doesn't wear gloves while treating you.
  • Another patient gets infected.
  • You finally get diagnosed with C. diff and properly treated -- ironically, with antibiotics.

McDonald says that this constant interplay between different kinds of health care facilities keeps C. diff in circulation. Half of cases diagnosed in hospitals are in patients already infected when admitted to the hospital.

"That means hospitals are partly at the mercy of surrounding facilities," McDonald says. "Because patients often transfer back and forth, an infection in one place can easily become a problem in another. This points to strict need for prevention across all facilities."

In a pilot project, 71 hospitals in Illinois, Massachusetts, and New York -- with a catchment area of 111 acute-care facilities and 310 nursing homes -- collaborated to stop C. diff spread. Over 19 to 22 months, the hospitals cut C. diff infections by 20%.

And more can be done. In the U.K., a concerted effort to reduce C. diff cut the infection rate in half.

C. Diff Prevention: What You Can Do

Here's the CDC's advice on what patients can do to stop C. diff:

  • Antibiotics are lifesaving medicines, but do much more harm than good when you don't need them. Don't beg your doctor for an antibiotic prescription if he or she doesn't think you need one.
  • Take antibiotics as prescribed, and only as prescribed.
  • Tell your doctor if you have been on antibiotics and get diarrhea within a few months.
  • Wash your hands -- carefully -- after using the bathroom.
  • If you have diarrhea, try to use a separate bathroom from the rest of the family. Be sure a bathroom is cleaned well if someone with diarrhea has used it.

If you are a caretaker for a person with C. diff infection, wear gloves during active treatment. Then clean your hands thoroughly. If the patient is using the bathroom, clean it well with a bleach solution or another EPA-approved, spore-killing disinfectant.

The CDC study appears in the March 6 early-release issue of MMWR.

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