Research shows effect of C. difficile infections on hospital stays

Pauline Tam, Postmedia News 

Research shows effect of C. difficile infections on hospital stays

One of the most effective ways to halt the spread of C. difficile is to encourage front line health-care workers and hospital visitors to clean their hands regularly.

Photos.com / canada.com


OTTAWA — The deadly Clostridium difficile superbug increases the length of a patient's hospital stay by at least six days, a team of Ottawa researchers has found.

Generally, the sicker the patient and the longer and more frequently they spent time in hospitals, the greater their risk of catching C. difficile's telltale symptoms of diarrhea, stomach pain and bowel inflammation.

Compared to younger and healthier counterparts, sicker and older patients also had a higher risk of remaining in hospital longer, which increased their chances of developing severe C. difficile symptoms that could lead to life-threatening complications.

Of the estimated 25,000 diagnosed cases in Canada each year, one in 10 patients die from the infection.

Longer hospital stays from C. difficile not only compromise patient safety, they also cost the health-care system untold millions each year, said Dr. Alan Forster, lead author of the study published Monday in the Canadian Medical Association Journal.

Forster and his research team combed through the records of nearly 137,000 patients at The Ottawa Hospital over seven years and identified 1,393 cases of lab-confirmed C. difficile.

Of the patients who got the intestinal infection, half ended up hospitalized for at least six days longer than patients without C. difficile. The other half remained for even longer.

A University of Texas study has estimated that the total cost of treating a single patient with C. difficile can range from $2,900 to $8,600. A patient with recurring C. difficile can cost as much as $18,000.

Forster said because of flaws in the way the study was conducted, the Texas estimates are likely overstated, which is why he and his collaborators want to use their own data to come up with more accurate figures.

"I would want there to be pressure on organizations to invest money to prevent this infection," said Forster, a senior scientist at the Ottawa Hospital Research Institute.

"That's one of the reasons we did this work. It's so that we could say to government and hospital decision makers, 'OK, look guys, if we do nothing, this is what it's going to cost hospitals on an annual basis.' "

C. difficile is typically triggered by antibiotic use. The drugs wipe out the targeted illness, but also kill off the healthy bacteria that normally live in the digestive tract. That allows harmful levels of C. difficile, which is resistant to most antibiotics, to take over.

Only two antibiotics are currently used to treat C. difficile: metronidazole and vancomycin.

In hospitals, the bug is commonly spread through contact with infected feces on contaminated surfaces. The most effective ways to prevent outbreaks are to isolate infected patients in private rooms, disinfect rooms thoroughly and encourage front line health-care workers and hospital visitors to clean their hands regularly.

Infections and deaths from C. difficile have increased sharply since the 1990s, in part because of the emergence of a more virulent strain.


