Clostridium difficile can be deadly. Clostridium difficile is everywhere. Clostridium difficile affects hospitalized patients and those living in nursing homes. A nasty intestinal superbug, Clostridium difficile is back in the news after it has been blamed for an uptick in deaths in the United States, Canada, and also the United Kingdom. Do you know how to protect yourself?
What is Clostridium difficile?
Clostridium difficile is the name of a strain of bacteria that thrive in environments devoid of oxygen. These bacteria are linked to colon infections termed Clostridium difficile colitis, and in some cases have been known to cause an abnormal and sudden dilation of the colon that the MedlinePlus Medical Encyclopedia recognizes as being fatal if left untreated.
What are your odds of becoming infected with Clostridium difficile?
Dr. Jennifer Curry of the Infectious Diseases Service at the Naval Medical Center at San Diego explains that out of 200 patients admitted to the hospital, one will be affected by Clostridium difficile.
What makes you susceptible to infection with Clostridium difficile?
Dr. Curry points out (and studies conducted as early as 1978 confirm) that at the greatest risk of contracting Clostridium difficile colitis are those who recently underwent any kind of treatment involving antibiotics. In an alarming finding it was revealed that it is not necessary for a patient to have undergone an entire treatment cycle with antibiotics to be at risk, even just the use of one single dose will do!
In addition to the foregoing, gender matters and women are more likely than men to develop Clostridium difficile colitis after exposure to the bacteria.
Other risk factors include the use of stool softeners, enemas, and any other agents that directly change the composition of the gut flora present in the gastrointestinal tract.
What are the odds of dying after being infected with Clostridium difficile?
Assuming that you will present with Clostridium difficile colitis while in a hospital or under medical care, your odds of survival are excellent. It is the patient who is either not diagnosed as having the illness or who fails to seek out medical attention that is at greatest risk, and Dr. Curry estimates that delayed treatment leading to complications which result in death accounts for a 30% mortality rate.
A recurring bout of Clostridium difficile colitis — which Dr. Curry states is indicated in one third of patients — increases the risk of death.
How do you know if you have Clostridium difficile colitis?
The at risk timeframe spans about 10 weeks after the last dose of antibiotics treatments are delivered and the most commonly noted period of symptom development takes place on the fifth day after the first dose of antibiotics was administered.
Although not each and every gastrointestinal problem that crops up after antibiotics use is related to Clostridium difficile, exposure to caregivers who also provided healthcare services to patients who are currently suffering from Clostridium difficile colitis puts you at immediate risk. The spores of the bacteria may be attached to their hands and if you ingest some of them, the infection is transmitted to you as well.
Initially you will suffer from watery yet extremely foul smelling diarrhea and the odds are good that this will also be accompanied by fever. In addition, you may suffer from intermittent cramping, severe nausea, and at times bowel movements with concurrent vomiting.
How do doctors treat Clostridium difficile colitis?
The first step is a diagnosis which may be accomplished with a stool sample; most physicians now err on the side of caution and do not await the results of the cultures which grow rather slowly. Instead, assuming a diagnosis of Clostridium difficile, doctors immediately discontinue any antibiotics treatments.
Thereafter it is crucial to restore electrolyte balances and to do so dehydration needs to be counteracted. Most likely this is all that is required and Dr. R. Nelson of the Northern General Hospital in the United Kingdom suggests that the condition will resolve itself in as little as two to three days.
Severe cases are also treated with medication aimed at neutralizing this specific strain of bacteria. Most notable are bacitracin, teicoplanin, metronidazole, and vancomycin, yet according to the Infectious Diseases Society of America it is the latter two which offer relief and cure to more than 95% of treated patients.
In the meantime, you will be isolated and healthcare providers will take added precautions to avoid transmitting Clostridium difficile to other patients.
In cases where complications occur – most notably a dilated colon – colectomy surgery is required to save the life of the patient.
Just the facts, ma’am: is it time to head for the bunker and stock up on canned beans?
Even though the press likes to sensationalize outbreaks of Clostridium difficile colitis and associated complications since it makes for great fear inspiring drama, stories entitled “Hospital bug death shock,” “Superbugs MRSA and Clostridium difficile killing record numbers of patients,” or “New Gut Superbug Increasingly Responsible for Illness and Death” need to be taken deadly serious since they point to an alarming trend.
Granted, the fact that even confirmed outbreaks have a low mortality rate when compared to the overall hospitalized population should be reassuring. Of course, if it happens to you or a loved one all bets are off and statistics really mean precious little.
What is concerning, however, is mentioned almost as an afterthought to a sensational article published by the UK’s Metro magazine while reporting on a “killer bug” known to cause infection via showerheads and taps. The article mentions that in Great Britain 6,480 officially issued death certificates listed Clostridium difficile but what is truly alarming is the fact that it represents a 72% increase of listed cases since 2005.
Patients at any hospital will be wise to discuss treatments for their conditions in the hopes of finding those that do not involve the use of antibiotics or other gut flora altering procedures. At the same time, remember that you are perfectly within your right to ask your doctor or nurse to please wash her or his hands or put on (new) gloves prior to treating you.
Sources:
http://www.nlm.nih.gov/medlineplus/
http://www.emedicine.com/
http://www.ncbi.nlm.nih.gov/pubmed/77366
http://www.ncbi.nlm.nih.gov/pubmed/17636768
http://www.journals.uchicago.edu/
http://www.metro.co.uk/
