SOME 40 patients a week in Irish hospitals are testing positive for the potentially fatal superbug Clostridium difficile, it was confirmed yesterday.
At the beginning of this month it became mandatory for laboratory-confirmed cases of the infection to be reported to the national Health Protection Surveillance Centre (HPSC). The director of the centre Dr Darina O'Flanagan has confirmed over 100 cases have been reported so far. She said about 40 cases were being reported every week. Most cases so far were in the east and south.
Dr O'Flanagan said it was not possible to say how many of these cases would prove fatal. However she said it was known from international studies that 25 to 30 per cent of people who have the infection can die with it, not necessarily from it. Patients who contract the infection may have an underlying illness.
She was speaking following the publication of a report from a subcommittee of the HPSC providing guidance on the surveillance, diagnosis, management, prevention and control of C. difficile.
The report, which comes in the wake of reports of several deaths associated with C. difficile last year at Ennis General and Loughlinstown hospitals, said ring-fenced funding must be provided by the Department of Health and the Health Service Executive to help hospitals meet the new guidelines.
More staff and isolation facilities are required, it says.
It recommends patients who contract the diarrhoeal-type infection should be promptly isolated and their doctor should be informed of their diagnosis.
It also warns that attempts to reduce waiting times for patients in AE "should not compromise the appropriate care and isolation of patients" with C. difficile.
Furthermore the report says education on infection prevention and control should be mandatory for all healthcare workers and it urges prudence in relation to antibiotic prescribing.
It calls for greater testing for and surveillance of the infection, and also for the setting up of a national reference laboratory for tracking strains of C. difficile in circulation. The virulent 027 strain is associated with higher mortality.
Overall it says the Department of Health and HSE "must prioritise prevention of healthcare associated infection in order to improve patient care and safety".
The subcommittee notes in its report that while some aspects of the recommendations "may be difficult to implement initially due to a lack of facilities or insufficient personnel, we strongly believe that these guidelines represent best practice".
And while individual cases of C. difficile were not reported to the HPSC up to now, the subcommittee's report states that 11 outbreaks of C. difficile were reported to the centre between January 2004 and December 2007. Seven of these were in acute hospital settings and four in residential institutions.
Dr Fidelma Fitzpatrick, chairwoman of the subcommittee, said the number of weekly reports of the infection since the beginning of this month were in line with what would have been expected.
She said the guidelines were very practical and an information leaflet had also been devised for patients.
Minister for Health Mary Harney, who attended the publication of the report, said she would take advice on the setting up of a C. difficile reference laboratory, but when asked if there was funding to ensure hospitals could implement the new guidelines she said it was essentially a matter for the HSE to implement them and to prioritise resources.
She said the HSE had set targets to reduce healthcare-associated infections by 20 per cent over a five-year period.