C Diff explained

MARK NICHOLLS Clostridium difficile is turning into the new killer bug that is sweeping the NHS.


By Mark Nicholls

Health Correspondent

Clostridium difficile is turning into the new killer bug that is sweeping the NHS.

It is taking over from MRSA as the most dangerous of hospital-acquired infections and believed to now be linked to twice as many deaths as MRSA, though it is equally present in the wider community.

However, the Norfolk and Norwich University Hospital reported that out of 2,396 hospital deaths last year, six were from c.dif and nine through MRSA. West Suffolk Hospital at Bury St Edmunds said it had no deaths but figures were not available last night from Queen Elizabeth Hospital at King's Lynn

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The other key hospitals alongside JPH report an ongoing battle with c.dif and say they have been aware of the JPH outbreak and have been closely monitoring patients as a result.

Expert opinion is still divided on whether the 027 strain - the one which affected patients at the James Pages University Hospital in Gorleston - is any more dangerous than other strains of the bug.

While West Suffolk reports no cases of 027, the N&N has had one case of that strain in the last couple of months and point out the patient made a full recovery, while QEH say its experts believe 027 makes up a significant portion of c.dif outbreaks.

Health Protection Agency (HPA) figures, which cover the period January-September 2006, show that the N&N had 224 cases of c.dif but when compared to the number of patients it treats, has the lowest incidence in the region. The JPH had 226 cases, West Suffolk Hospital (281) and the King's Lynn NHS Trust (261).

The QEKL figures so far this year stand at 276, compared to 369 the previous year, while GP practices in that area reported 63 cases.

QEKL spokesman Richard Humphries said: “The 027 strain has been going around for some time but we are still waiting for evidence to show that it is more dangerous than any other strain.”

Cases of c.dif have been rising in the past few years and now outstrip MRSA fatalities. Deaths involving c.dif rose by 69pc to 3,800 from 2004-05, the Office for National Statistics said. In the same period, MRSA mentions on death certificates increased by 39pc to 1,629.

The bug causes severe diarrhoea and while naturally occurring in the gut of otherwise healthy adults, it becomes a problem when the natural bacteria in the gut are killed off by antibiotics used to treat other illnesses. The elderly are most at risk.

But while it can be easily spread, it is easier to treat than MRSA.

There have been a number of serious outbreaks in the UK in recent years. It killed 15 people in Northern Ireland in 2004 and was a contributory factor in 12 deaths in two Nottingham hospitals last November and December.

The 027 strain of the bacterium caused several deaths at Stoke Mandeville hospital in Buckinghamshire, while more than 80 hospitals in England and Wales fought outbreaks last year

An inquiry found that “serious failings” in infection control were responsible for the deadly spread of a hospital bug at Stoke Mandeville.

The Healthcare Commission said senior managers put NHS targets above outbreak control and failed to follow advice.

Two outbreaks of c.dif at the Aylesbury hospital resulted in at least 33 deaths, higher than the 12 previously thought.

Commenting on the JPH outbreak last night , Dr Paul Cosford, East of England NHS Director of Public Health, said: “We have been working closely with the Foundation Trust, the Primary Care Trust and Health Protection Agency to bring the full weight of our combined expertise and resources to bear in dealing with this situation.

“The hospital has been diligent in following the actions recommended in dealing with such a situation and they have our support in their actions, including the move to full isolation. We, with others, will continue to support the Trust in moving forward and dealing with this situation as effectively and quickly as possible.”