While hospitals are meant to save lives, they come with some major risks, including lethal infections that, according to the US Centers for Disease Control and Prevention, affect 1 in 25 patients. But for the first time in decades, that statistic is going down, thanks to new guidelines on antibiotic use and stricter cleaning standards in care facilities.
Researchers found that, year after year, from 2000 to 2011, the rate of new Clostridium difficile or C. diff infections continued to climb. However, 2011 to 2014 data from the CDC’s Emerging Infections Program has found that infection rates are finally improving.
“Preliminary analyses suggest a 9 to 15 percent decrease in health care [C. diff] incidence nationally,” says Dr. Alice Guh, a medical officer at the CDC. “It’s very encouraging, but there’s still a lot to do.”
C.diff infections most commonly cause severe diarrhea and stomach pain. But for others, it can be deadly, with the CDC estimating that, in 2011, it claimed the lives of about 29,000 people and caused nearly 500,000 illnesses in the U.S., over three times the number in 2000.
“In a nursing home, 20 to 50 percent of residents are colonized with it at any point,” says Dr. John Haran, an assistant professor of emergency medicine at the University of Massachusetts Medical School.
Many people who carry the bacterium don’t experience any disease, largely in part due to bacteria in the gut helping keep it in check. However, certain antibiotics can harm the natural human microbiome, allowing C.diff to take over.
Antibiotic overuse has resulted in certain bacteria becoming resistant to even the most powerful antibiotics. The problem is so bad that the CDC refers to it as “one of the world’s most pressing public health problems.”
C.diff became so prevalent in hospitals that, in 2011, it became notorious for taking lives in a hospital setting. The epidemic forced hospitals to implement antimicrobial stewardship programs to confront the infection head on, which included guidelines to restrict unnecessary antibiotic prescriptions, along with new, stricter cleaning and infection control protocols.
As with many diseases, older people are more susceptible to the infection. They are most at risk for being exposed to the spores in hospitals and nursing more, and more likely to be prescribed antibiotics as well.
“In the Medicare population, the rates are many times higher than in younger patients,”says Dr. Dale Gerding, who directs the research lab at the Edward Hines Jr. Veterans Affairs Hospital in Chicago. “The recurrence rate also goes up. Mortality goes up probably 10 percent with every decade.” More than 80 percent of deaths associated with C. diff occur in those over 65, according to C.D.C. data.
While the CDC is still in the midst of examining statistics, and won’t issue a report until later this year, Guh calls the new guidelines and protocols a move “in the right direction.”
It seems better cleaning and fewer antibiotics have done more than just lessen C.diff and other dangerous infections, with new data from the Institute for Health Metrics and Evaluation in June revealing a decrease in all diarrheal disease deaths in the United States from 2010 to 2015.
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