CDC warns careful use of antibiotics
LIFE-threatening infections caused by bacteria called Clostridium difficile, simply known as C. difficile, now sicken nearly half a million Americans in one year, said health officials on Wednesday, Feb. 25.
The number of these infections—which can cause “deadly diarrhea” and damage to the colon—doubled between 2000 and 2010, according to the Centers for Disease Control and Prevention (CDC).
In 2011, about 29,000 patients with the bacteria died within a month of becoming sick, according to the CDC study published Wednesday in The New England Journal of Medicine. One out of three of these infections occurs in people 65 and older, who also account for most deaths.
“C. difficile infections cause immense suffering and death for thousands of Americans each year,” said CDC Director Dr. Tom Frieden in a statement.
Though the infections are often treatable with antibiotics, toxins released by the bacteria can severely damage the colon, forcing doctors to remove it, said CDC spokesman Michael Bell, who specializes in drug-resistant pathogens and hospital-acquired infections.
C. difficile is the most common healthcare-associated infection in the nation, costing hospitals around $4.8 billion a year, the CDC reported.
About two-thirds of infections developed in patients with a recent hospital stay, although symptoms often set in only after discharge. About 100,000 C. diff infections a year are diagnosed in highly-contagious places like nursing homes.
More than 80 percent of patients who pick up C. diff outside of hospitals had visited outpatient doctor’s or dentist’s offices in the previous 12 weeks, said the CDC. The bacteria are hardy and can live on bed linens, bathroom fixtures, and medical equipment. Soap and water can usually wash off the bacteria, but hand sanitizers don’t quite kill it.
Instead, the CDC recommends that doctors treating C. diff patients wear disposable gowns and gloves.
“The numbers are pretty striking,” said Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, who was not involved in the new study. “A substantial number of cases are occurring in people who have never been to a hospital.”
Even the healthiest people can develop C. diff infections after taking antibiotics for illnesses as mild as urinary tract infections, or even bronchitis, said Fernanda Lessa, the CDC study’s lead author.
“Although antibiotics can save lives, they can also wipe out huge numbers of helpful bacteria that live in the digestive tract,” said Amesh Adalja, a senior associate at the Center for Health Security of the University of Pittsburgh Medical Center.
“These bacteria normally keep the body health by competing with dangerous bacteria and keeping them in check,” Adalja added. “Antibiotics interfere with this delicate balance, killing off beneficial bacteria and allowing harmful ones to gain a foothold.”
More than half of hospitalized patients are prescribed antibiotics as treatment. Yet, studies show that 30 to 50 percent of these prescriptions are unnecessary or incorrect. Health care providers can help prevent C. diff infections “by prescribing antibiotics only when they’re really needed,” Frieden said in his statement.
The authors of the new study agreed that the US should do more to prevent the infections in doctor’s offices and clinics, and were looking to other nations as leading examples. England, for instance, has reduced the number of C. diff infections by more than 60 percent by encouraging people to use antibiotics more carefully. A study from a Canadian hospital also found that reducing antibiotic use 10 percent was associated with a 34 percent drop in C. diff cases.
People who are prescribed antibiotics should take the full dose exactly as prescribed, instead of stopping medications because they might feel better, the CDC said.
In recent years, doctors have had success treating C. diff with fecal transplants, which supposedly help restore the gut’s normal bacteria. A smaller study from last year also found that the transplants cured 94 percent of C. diff patients.
(With reports from USA Today)
(LA Weekend February 28 – March 3, 2015 Sec. A pg.7)