Nav: Home

Clostridium difficile infections have decreased 36 percent in Canadian hospitals

June 25, 2018

Rates of C. difficile infections have decreased 36% in hospitals across Canada, although the virulent NAP1 strain associated with severe illness and deaths is the most common strain, according to research published in CMAJ (Canadian Medical Association Journal)

Clostridium difficile is the most common infectious cause of diarrhea in hospitalized patients in developed countries, causing severe illness and occasionally death. Seniors and people on antibiotic treatment are most vulnerable to infection. However, the NAP1 strain of C. difficile, which is most virulent and can be resistant to treatment with fluoroquinolone antibiotics, has emerged in healthy people and in the community, spreading after several epidemics in the early 2000s.

A pan-Canadian team of researchers from the Canadian Nosocomial Infection Surveillance Program looked at data from 42-53 acute care hospitals over 7 years (2009-2015) to understand patterns of NAP1 strain and effect of infection on patient outcomes. A total 20 623 cases of hospital-acquired C. difficile occurred, mostly in hospitals with more than 200 beds. Infection rates decreased 35.8% across Canada by 2015, although the number of younger patients with the disease increased.

Improvements in infection-control measures (such as improved testing, more judicious use of antibiotics, frequent handwashing, and better and more frequent cleaning of facilities) begun after outbreaks 10-15 years ago may have contributed to the decrease in infection rates.

The large study found an association between the NAP1 strain and death in patients aged 18 and older, not detected by earlier single-centre or provincial-level studies.

"Our findings suggest that, as the proportion of NAP1 strain isolates decreases in relation to all circulating strains, both the rate of health care-associated C. difficile infection and the number of severe cases can be expected to decrease relative to a peer hospital with a higher proportion of NAP1 circulating isolates," says Dr. Kevin Katz, North York General Hospital, Toronto, Ontario.

The authors recommend continued vigilance to better contain infection.

"Infection prevention and control practices, antimicrobial stewardship and environmental cleaning should continue to be strengthened at the local level, as these areas positively affect institutional rates of health care-associated C. difficile infection, regardless of circulating strain types."
-end-
"The evolving epidemiology of Clostridium difficile infection in Canadian hospitals during a postepidemic period (2009-2015)" is published June 25, 2018.

Visual abstract: https://bit.ly/2M3mrAD

Canadian Medical Association Journal

Related Health Care Articles:

Large federal program aimed at providing better health care underfunds primary care
Despite a mandate to help patients make better-informed health care decisions, a ten-year research program established under the Affordable Care Act has funded a relatively small number of studies that examine primary care, the setting where the majority of patients in the US receive treatment.
International medical graduates care for Medicare patients with greater health care needs
A study by a Massachusetts General Hospital research team indicates that internal medicine physicians who are graduates of medical schools outside the US care for Medicare patients with more complex medical needs than those cared for by graduates of American medical schools.
The Lancet Global Health: Improved access to care not sufficient to improve health, as epidemic of poor quality care revealed
Of the 8.6 million deaths from conditions treatable by health care, poor-quality care is responsible for an estimated 5 million deaths per year -- more than deaths due to insufficient access to care (3.6 million) .
Under Affordable Care Act, Americans have had more preventive care for heart health
By reducing out-of-pocket costs for preventive treatment, the Affordable Care Act appears to have encouraged more people to have health screenings related to their cardiovascular health.
High-deductible health care plans curb both cost and usage, including preventive care
A team of researchers based at IUPUI has conducted the first systematic review of studies examining the relationship between high-deductible health care plans and the use of health care services.
More Health Care News and Health Care Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Erasing The Stigma
Many of us either cope with mental illness or know someone who does. But we still have a hard time talking about it. This hour, TED speakers explore ways to push past — and even erase — the stigma. Guests include musician and comedian Jordan Raskopoulos, neuroscientist and psychiatrist Thomas Insel, psychiatrist Dixon Chibanda, anxiety and depression researcher Olivia Remes, and entrepreneur Sangu Delle.
Now Playing: Science for the People

#537 Science Journalism, Hold the Hype
Everyone's seen a piece of science getting over-exaggerated in the media. Most people would be quick to blame journalists and big media for getting in wrong. In many cases, you'd be right. But there's other sources of hype in science journalism. and one of them can be found in the humble, and little-known press release. We're talking with Chris Chambers about doing science about science journalism, and where the hype creeps in. Related links: The association between exaggeration in health related science news and academic press releases: retrospective observational study Claims of causality in health news: a randomised trial This...