C. difficile epidemic should concern not only hospital patients but people at home
While mainly a concern in hospitals, cases of the C. difficile infection (or C. diff) are on the rise in the community, according to the
It particularly infects healthy people, and particularly pregnant women, said
Symptoms of C. diff include continual bouts of diarrhea, severe cramps, swollen stomach and intestinal irritation.
Potentially, the bacteria's toxins can cause ulcers and eventually eat through intestine walls, which allows infection to enter the blood.
"The article delivers practical advice to nurses and nurse practitioners on infection prevention and control activities in any setting," Kenneley said.
Based on CDC guidelines, she recommends:
• Isolating the patient (or, if possible, the person at home) when symptoms appear;
• Appropriate and timely lab testing to determine the type of bacteria present;
• Treating with appropriate antibiotics;
• Cleaning thoroughly (using bleach is best);
• Washing hands to stop the spread of further infections.
That last step, washing hands, is critical for hospital workers, family members and other visitors who have encountered someone with C. diff or is suspected to have contracted the bacteria.
It can take up to 96 hours to confirm a C. diff diagnosis. Because of the wait for a diagnosis, isolation of the patient is key-a practice similar to hospital protocol for patients with suspected tuberculosis.
Kenneley said these bacteria that can live as hibernating spores up to 100 years on surfaces until conditions are right to proliferate. The stomach and intestines offer that environment, once ingested.
Particularly at risk are people with compromised immune systems (HIV and transplant patients), those who are aging, recovering from gastrointestinal surgeries or are on antibiotics for more than three days to treat other illnesses.
C. diff has proliferated through use of broad-spectrum antibiotics that wipe out the healthy bacteria. A few antibiotics, such as vancomycin and metronidazole, have some success treating the infection, she said.
Poor hand-washing practices allow spores to travel between patients and other surfaces. Hand-washing must occur multiple times during patient care.
Kenneley recommends washing hands before entering a room, any time the hands touch a new surface in the room, and when exiting. And soap is more effective than alcohol-based hand sanitizers or wipes that do not destroy spores, she said.
Although hospitals clean rooms daily and after a patient leaves, some spores may still survive, Kenneley said, which is why the key to prevention is hand-washing.
Keywords for this news article include: Hospital, Clostridium difficile,
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