Is C. Difficile in Your Future?
“Far more could be done to stop the
deadly bacteria C. diff” – to read the article
in full, click here
By Peter Eisler, USA TODAY
“…A USA TODAY investigation shows that C. diff is far more prevalent than federal reports suggest.
The bacteria is linked in hospital records to more
than 30,000 deaths a year in the United States—
about twice federal estimates and rivaling the 32,000
killed in traffic accidents. It strikes about a half-million Americans a year….
“People are dying needlessly,” says Christian John Lillis,
a New Yorker who lost his 56-year-old mother,
Peggy, to the infection two years ago.
“It’s outrageous.”
•Deaths and illnesses are much higher than
reports have shown.
“…In March, the CDC said in a report that the infection
kills 14,000 people a year. But that estimate is based
on death certificates, which often don’t list the infection
when patients die from complications, such as kidney
failure…
…Hospital billing data collected by the federal Agency for Healthcare Research and Quality shows that more than 9% of C. diff-related hospitalizations end in death — nearly five times the rate for other hospital stays. That adds up to more than 30,000 fatalities among the 347,000 C. diff hospitalizations in 2010.
Thousands more patients are treated in nursing
homes, clinics and doctors’ offices….
…”We’re talking in the range of close to 500,000
total cases a year,” says Cliff McDonald, a
C. diff expert and senior science adviser in the
CDC’s Division of Healthcare Quality Promotion.
And annual fatalities “may well be …
as high as 30,000.”…
…That’s when the Environmental Protection Agency,
which regulates hospital disinfectants, learned that
none of its approved products actually killed
C. diff spores — though many claimed on their
labels that they were effective against the bacteria.
Five years passed, with C. diff rates skyrocketing,
before the agency ordered manufacturers to remove
the claims and began to identify new disinfectants
that work…
…”The agency blew it,” says Jim Jones, EPA’s
acting assistant administrator for the Office of
Chemical Safety and Pollution Prevention,
which handles disinfectant regulation.
“We missed something we totally had the
capacity to catch.”…
‘I couldn’t move’
…Like most C. diff patients, Bailey Quishenberry’s
symptoms began with severe diarrhea. Within days,
her intestines were shutting down. Her colon was so
swollen that it pushed pressure up to her lungs,
making it difficult to breathe…
…Bailey’s doctors at California’s Loma Linda University Medical Center diagnosed her with toxic megacolon, a sometimes fatal complication that often requires removal of the colon and use of a colostomy bag…
…”It was so painful, I couldn’t think, I couldn’t keep
track of what I was saying. … I couldn’t move,”
she recalls. “It was like … ‘I wish this would be over
and I could just die.’ “…
…With a colectomy looming, Bailey’s mother, Shannon,
persuaded the doctors to try an unusual alternative,
a fecal transplant. The goal is to repopulate the colon
with healthy bacteria by implanting a feces from a
relative, often via a colonoscopy or enema.
Within days, Bailey’s blood white cell count fell,
the swelling in her abdomen receded. After a month
in the hospital, she was allowed to go home….
…Bailey’s ordeal would continue, but she survived.
Many patients aren’t so fortunate….
…Regina Mulligan was diagnosed with C. diff after
entering a New York hospital for heart surgery and
died from complications three months later at 83….”
C. Diff. – No Joking Matter!
Empower yourself now with the facts.
Is C. Diff. in Your Future?
I’m sure most of you have heard
of C. Diff, it’s a very nasty,
virulent, opportunistic,
and tenacious bacteria, which
is generally very hard to get
rid of.
You can get C.Diff, from a dirty
toilet seat, from a colonoscopy
scope that hasn’t been properly
cleaned, some get it from staying
in the hospital, and yes! –
from taking antibiotics. YIKES!
Which antibiotics? Any of them.
What can you do to prevent getting C. Diff?
– Only take antibiotics IF you have no
other choice
– Make sure to supplement daily
with good multi strained antibiotics
(twice a day, and 3 hours apart from
the antibiotics).
– Make sure you drink plenty of clean water
– Make washing your hands a priority,
especially after leaving any establishment,
after seeing friends or co-workers, after
handling a menu at a restaurant, after using
the public restrooms… it just makes good sense!
If you must take antibiotics,
make sure to take these 4
different probiotics, twice a day
and 3 hours apart from the
antibiotics. Studies show
that there’s a 12 week window
within which you can get C. Diff.
after antibiotic use. Therefore,
my recommendation is to start
the 4 different probiotics protocol
(twice daily, and 3 hours apart
from the antibiotics) when you
START your antibiotics,
and continue for 12 weeks
AFTER stopping your
antibiotics!
These 4 probiotics have been shown
to help prevent C. Diff.:
Culturelle (click here for more info),
VSL#3 DS (click here for more info),
FloraCor-GI (click here for more info),
and S. Boulardii (click here for more info)
Whenever anyone in my family needs to take
Antibiotics for any reason, I have them add
these 4 probiotics to prevent C. Diff. – and
it works!
As Charles Bankhead explains in this article,
quoting various studies,
Probiotics May Prevent
C. Difficile Diarrhea ( Click here to read the entire article)
Here are some excerpts:
“…Patients at risk of Clostridium difficile–associated
diarrhea had a 66% lower infection rate when
they received prophylactic probiotics, results
of a meta-analysis showed.
Treatment with multispecies probiotics products
was associated with a 75% reduction in the risk
of C. difficile diarrhea, whereas single-species
products reduced the risk by 50%.
Serious adverse events were uncommon in
patients who received probiotics.
Antibiotics have a recognized potential to
disrupt gastrointestinal flora and predispose
patients to opportunistic infections of the
gastrointestinal tract. C. Difficile is the
pathogenic culprit that most often takes
advantage of the breakdown in colonization
resistance resulting from antibiotic treatment.
The spectrum of C. Difficile-realted diseases
ranges from asymptomatic colonization to
potentially fatal infection…”
What is C. Diff.?
Per the CDC (Centers for Disease Control):
“…Clostridium difficile (click here to see)
[klo–strid–ee–um dif–uh–seel] (C. difficile)
is a bacterium that causes inflammation
of the colon, known as colitis.
People who have other illnesses or
conditions requiring prolonged use of
antibiotics, and the elderly, are at greater
risk of acquiring this disease.
The bacteria are found in the feces.
People can become infected if they
touch items or surfaces that are
contaminated with feces and then
touch their mouth or mucous membranes.
Healthcare workers can spread the
bacteria to patients or contaminate
surfaces through hand contact.
Symptoms of C. difficile
Symptoms include:
- Watery diarrhea (at least three bowel movements per day for two or more days)
- Fever
- Loss of appetite
- Nausea
- Abdominal pain/tenderness
Transmission of C. difficile
Clostridium difficile is shed in feces. Any surface, device, or material
(e.g., toilets, bathing tubs, and electronic rectal thermometers) that
becomes contaminated with feces may serve as a reservoir for the
Clostridium difficile spores. Clostridium difficile spores are transferred
to patients mainly via the hands of healthcare personnel who have
touched a contaminated surface or item. Clostridium difficile
can live for long periods on surfaces.
Treatment of C. difficile Infection
Whenever possible, other antibiotics should be discontinued; in a small number
of patients, diarrhea may go away when other antibiotics are stopped.
Treatment of primary infection caused by C. difficile is an antibiotic such as
metronidazole, vancomycin, or fidaxomicin. While metronidazole is not
approved for treating C. difficile infections by the FDA, it has been commonly
recommended and used for mild C. difficile infections; however, it should not
be used for severe C. difficile infections. Whenever possible, treatment should
be given by mouth and continued for a minimum of 10 days.
One problem with antibiotics used to treat primary C. difficile infection is that
the infection returns in about 20 percent of patients. In a small number of
these patients, the infection returns over and over and can be quite debilitating.
While a first return of a C. difficile infection is usually treated with the same
antibiotic used for primary infection, all future infections should be managed
with oral vancomycin or fidaxomicin.
Transplanting stool from a healthy person to the colon of a patient with repeat
C. difficileinfections has been shown to successfully treat C. difficile. These
“fecal transplants” appear to be the most effective method for helping patients
with repeat C. difficile infections. This procedure may not be widely available
and its long term safety has not been established.
To read more on C. Diff, here’s a PDF, click here
Further, from the CDC, click here to see the article
“…Clostridium difficile Excerpt: Guideline for
Environmental Infection Control in Health-Care Facilities,
2003
Source: CDC. Sehulster L, Chinn RYW. Guidelines for environmental infection control in healthcare facilities. MMWR 2003;52(RR10);1–42.
7. Special Pathogen Concerns
b. Clostridium difficile
Clostridium difficile is the most frequent etiologic agent for health-care–
associated diarrhea. In one hospital, 30% of adults who developed
health-care–associated diarrhea were positive for C.difficile. One recent
study employing PCR-ribotyping techniques demonstrated that cases of
C.difiicile-acquired diarrhea occurring in the hospital included patients
whose infections were attributed to endogenous
C. difficile strains and patients whose illnesses were considered to be health-
care–associated infections. Most patients remain asymptomatic after infection,
but the organism continues to be shed in their stools. Risk factors for acquiring
C. difficile-associated infection include a) exposure to antibiotic therapy,
particularly with beta-lactam agents; b) gastrointestinal procedures and surgery;
c) advanced age; and d) indiscriminate use of antibiotics. Of all the measures that
have been used to prevent the spread of C. difficile-associated diarrhea, the most
successful has been the restriction of the use of antimicrobial agents.
C. difficile is an anaerobic, gram-positive bacterium. Normally fastidious in its
vegetative state, it is capable of sporulating when environmental conditions no
longer support its continued growth. The capacity to form spores enables the
organism to persist in the environment (e.g., in soil and on dry surfaces) for
extended periods of time. Environmental contamination by this microorganism
is well known, especially in places where fecal contamination may occur.
The environment (especially housekeeping surfaces) rarely serves as a direct
source of infection for patients. However, direct exposure to contaminated
patient-care items (e.g., rectal thermometers) and high-touch surfaces in
patients’ bathrooms (e.g., light switches) have been implicated as sources of
infection.
Transfer of the pathogen to the patient via the hands of health-care workers
is thought to be the most likely mechanism of exposure. Standard isolation
techniques intended to minimize enteric contamination of patients, health
-care–workers’ hands, patient-care items, and environmental surfaces have
been published. Handwashing remains the most effective means of reducing
hand contamination. Proper use of gloves is an ancillary measure that helps to
further minimize transfer of these pathogens from one surface to another.
The degree to which the environment becomes contaminated with C. difficile
spores is proportional to the number of patients with C. difficile-associated
diarrhea, although asymptomatic, colonized patients may also serve as a source
of contamination. Few studies have examined the use of specific chemical
germicides for the inactivation of C. difficile spores, and no well-controlled trials
have been conducted to determine efficacy of surface disinfection and its impact
on health-care–associated diarrhea. Some investigators have evaluated the use
of chlorine-containing chemicals (e.g., 1,000 ppm hypochlorite at recommended
use-dilution, 5,000 ppm sodium hypochlorite [1:10 v/v dilution], 1:100 v/v
dilutions of unbuffered hypochlorite, and phosphate-buffered hypochlorite
[1,600 ppm]). One of the studies demonstrated that the number of contaminated
environmental sites was reduced by half, whereas another two studies
demonstrated declines in health-care–associated C. difficile infections in a HSCT
unit and in two geriatric medical units during a period of hypochlorite use.
The presence of confounding factors, however, was acknowledged in one of
these studies. The recommended approach to environmental infection control
with respect to C. difficile is meticulous cleaning followed by disinfection using
hypochlorite-based germicides as appropriate. However, because no EPA-
registered surface disinfectants with label claims for inactivation of C. difficile
spores are available, the recommendation is based on the best available evidence
from the scientific literature…”
Recommendations
VI. Special Pathogens
G. Because no EPA-registered products are specific for inactivating
Clostridium difficile spores, use hypochlorite-based products for
disinfection of environmental surfaces in those patient-care areas
where surveillance and epidemiology indicate ongoing transmission of C. difficile.Category II…”
And what if you still get C. Diff?
Get FMT, it’s FDA approved for C. Diff, and quite effective.
Click here to read about it
Mayo Clinic calls it an “inexpensive and 90% cure rate”.
For further info, this paper, entitled “Fecal
Transplantation for the treatment of C. Diff infection”
click here to read it.
For tips how to clean C. Diff
laundry, surfaces, your home
environment, and what to do
after you leave the hospital:
Click here to find out how/what to clean
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