Hospital C. diff Infections Survey Finds Prevention Improvements and Failures

A nationwide survey of infection prevention specialists in U.S. hospitals has found that many do not believe their facilities are doing enough to fight the spread of Clostridium difficile (C. diff), a sometimes deadly hospital-acquired infection. 

The survey, the 2010 CDI Pace of Progress (pdf), was conducted by the Association for Professionals in Infection Control and Epidemiology (APIC). It found that while 53 percent of the specialists surveyed indicated that their hospitals were doing more to fight C. diff., less than 25% actually added more infection prevention staff.

C. diff lives in the human gut and its spores can be found in feces. It can live for weeks on hard surfaces and can withstand cleaning by many disinfectants and alcohol-based sanitizers and still live on to infect humans. C. diff causes intestinal infections that can be very painful and in rare cases can be deadly.

According to the U.S. Centers for Disease Control and Prevention, There are about 215,000 hospital C. diff infections in the U.S. each year, and 263,000 cases of nursing home C. diff infections. The bacteria claims about 9,000 lives in the U.S. annually.

APIC became concerned about the spread of C. diff infections (CDIs) after a 2008 survey found that the rate of infections from C. diff was between six and 20 times greater than expected. In addition, stronger strain has appeared since the turn of the century that resists treatment and increases the risk of death for patients.

In March, a report presented by Duke University researchers at the Fifth Decennial International Conference on Healthcare-Associated Infections in Atlanta revealed that C. diff infections were on course to outpace other types of infections. They also found that 90% of all hospital C. diff infections occurred after the patient had been given antibiotics. Researchers said this could be because the antibiotics kill off much of the helpful bacteria in the gut that helps the body fight off infections like C. diff.

But the APIC survey shows that hospitals think they have things under control, despite the increase of C. diff, 45 percent of institutions that have made no infection prevention improvements in the last 18 months say C. diff infections are not listed as a high-priority problem. About 34% of the prevention specialists surveyed overall think their hospitals are not doing enough to fight C. diff infections.

The survey found an increase in the use of basic preventative steps which many experts say will make a big difference in fighting hospital-acquired infections of all kinds. For example, 83% of hospitals have facility-wide hand washing programs, according to the survey, and 89% of those use unannounced hand hygiene observations to make sure their staffs are complying with proper procedures.

In recent years, there has been an increasing number of hospital infection lawsuits filed throughout the United States, as experts believe that most of these potentially life-threatening hospital infections can be prevented if steps are taken by the facility and staff.

These steps could include improved methods of handling catheter during insertion, leaving them in for shorter periods and improved hygiene. Many hospitals have instituted new rules to ensure that hands are washed and increased efforts are being taken to keep areas lie the ICU more sterile and catheters clean.