C-diff, the latest superbug

CHECK-UP: Clostridium difficile can cause major problems for older or debilitated patients.

CHECK-UP:Clostridium difficile can cause major problems for older or debilitated patients.

THERE HAS been a lot in the news about the bug Clostridium difficile which I had never previously heard of. Can you explain what exactly it is?

Clostridium difficile is a bug that is thought to live in the intestines of about 5 per cent of healthy adults. And for these healthy adults it causes no problem as their balance is kept in check by other bugs found naturally in the gut.

For many who become infected with clostridium difficile, the resulting illness may be relatively mild, but for older patients or those who are debilitated and who have had a recent course of antibiotic treatment, it can cause major problems. In these people, infection with the bacteria can cause severe diarrhoea as well as abdominal pain and high temperature. Dehydration may occur as a result, leaving the already debilitated patient at risk of becoming seriously ill.

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The condition can, in some instances, lead to severe inflammation of the colon or cause a very serious form of colitis to develop which may result in perforation of the bowel itself.

What has the use of antibiotics got to do with it?

Inappropriate or unnecessary use of antibiotics in the general population, particularly for viral infections, has led to a wide range of bugs becoming resistant to available treatments. This in turn has allowed certain bacteria to proliferate, resulting in serious illness for some.

While clostridium difficile and other microbes such as MRSA or the norovirus (the winter vomiting bug) are more likely to occur in hospitals or nursing homes, they can also occur in the community setting.

What can hospitals do to prevent the spread of such bugs?

Until now clostridium difficile was not a notifiable infectious disease, but from next month all cases must be reported to the Health Protection Surveillance Centre.

Having proper infection control procedures in place, ensuring thorough hand-washing by staff and visitors, identifying patients with the infection and treating them in isolation will help prevent and contain outbreaks of this type of infection.

Better monitoring of antibiotic prescribing within hospitals and the appropriate use of these medicines in the greater community will also help prevent potential outbreaks of this and other infections.

CLOSTRIDIUM DIFFICILE - THE SYMPTOMS

The predominant symptoms of infection with Clostridium difficile are diarrhoea, fever and abdominal pain.