Rethinking C. difficile Prevention

Rethinking C. difficile Prevention

Expanding Our Awareness and Necessary Prevention Efforts

Clostridium difficile infection, commonly referred to as CDAD, CDI, or simply C. diff, is one of the greatest infection control challenges facing our healthcare system today.  Within the past decade, we have witnessed patient mortality from this deadly GI bacteria skyrocket more than 400% with the emergence and evolution of even stronger strains1.  The CDC reports that C. diff causes more than 60% of the 23,000 patient deaths it estimates that occur every year from bacteria that has become resistant to the very antibiotics used to treat them1.  Even this may be grossly underestimated, with independent research suggesting a nearly 8 times (8X) higher rate of mortality, exceeding 109,000 patients annually, from C. diff alone2.  This equates to five patients contracting CDI every minute of every day, and one patient death every 5 minutes from this preventable, though deadly infection2.  The economic costs of C. diff are devastating as well, at up to $35k for a single inpatient infection and annual cost estimates ranging from $3 billion to more than $20 billion in the U. S. alone 2-5.  Based on the the critical nature of these risks, the CDC has recently classified C. diff as #1 among Urgent Threats for antibiotic-resistant pathogens, joined only by CRE (Carbapenem-resistant Enterobacteriaceae) and drug-resistant Neisseria gonorrhoeae in this highest risk category.1

Despite the significant amount of research focused on reducing the risks and controlling the threat of C. diff, admittedly only limited progress has been made in the efforts to tackle this problem that continues to threaten our hospitals and healthcare facilities.  In its recent “Pace of Progress” survey, the Association for Professionals in Infection Control (APIC, 2013) stated that even with infections caused by C. diff reaching historic highs, only 42% of facilities have seen any decline in their rates of C. diff -related HAI’s over the past 3 years.6  This same survey reflected an even greater number of facilities (43%) reporting they had been unable to reduce CDI infection rates despite the adoption of additional CDI intervention measures at a vast majority of facilities.

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