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Hospital Acquired Infections and C. diff. Is My Hospital Safe?

If any reader has heard of C. difficile, affectionately known as C. diff, than I presume you have had closer contact with this germ than you would have liked.  It’s an infection of the colon that can be serious, or even fatal.  There isn’t a hospital in the country that isn’t battling against the infection.  

We are not winning the war against this crafty and cunning adversary. 

We Need Better Weapons Against C. diff

While the infection is not new, the strength and seriousness of current strains of the germ have tilted the odds against doctors and our patients.  The infection usually is a ‘side-effect’ of antibiotic treatment, but it can also be contracted from infected surfaces and people that reside in hospitals and extended care facilities and nursing homes.  For example, nowadays a patient can be admitted to a hospital and pick up the germ from hospital personnel who are contaminated from contact with an actual C. diff patient.  For this reason, C diff patients are kept in a form of isolation to protect against spreading the disease.  When a C. diff patient is discharged, the room must be scrupulously cleaned.  Hospital housekeepers today have an incredibly important job for reasons that need not be explained.  While my intent is not to frighten readers, every room in your hospital has likely housed a C diff patient at one time or another. 
  • Imagine the consequences if hospital rooms are not cleaned fastidiously every time?
  • Imagine the risk to patients if personnel do not observe proper handwashing techniques?
  • Imagine the hazard from overuse of antibiotics which are a known risk of C. difficile?
C. diff is not a simple infection like a urinary tract infection that can be easily wiped out. It can be severe and stubborn. The germ has a spore form where it stays protected within a type of armor and can survive on surfaces for months.  This is why it is so tough for hospitals who are striving every day to destroy these millions of microscopic germs who resist attack and hide in waiting.  It’s not really a fair fight.

Some patients carry the infection for life.  Many have died from it.  It’s especially tragic when a patient battles against C. diff which resulted from antibiotics that were not necessary in the first place.  Think of this when your dentist insists on giving you antibiotics because you have a heart murmur of have an artificial joint, neither of which is supported by medical evidence.

There’s a new treatment called fecal transplantation, where healthy donor stool is introduced into the C diff patient’s digestive system and cures an infection that seemed to be chronic and incurable.  In my view, this is a game changer and I predict that every hospital in America will offer it in the forseeable future.
 
My advice?  Refuse any antibiotics advised by any physician, including me, unless the doctor makes a case for them beyond a reasonable doubt. 


Comments

  1. i just came across your excellent blog, so please excuse the tardiness in responding to this column. I am sure at your hospital you hear the frequent siren call of "sepsis Alert" overhead, the clarion call to overdiagnose and over treat routine infections with overly broad antibiotics. Did we really miss so many cases of true sepsis in years past? I dont think you or I were that obtuse. No, the main reason why is that adding sepsis to the bill increases the hospitals reimbursement by $5000, a not trivial sum. Overuse of antibiotis like zosyn and vanco, the drugs of choice here, leads inevitably to increased resistance and an increase in c diff infections, a conclusion reached by a CDC study from Sept 2016

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