Hospitals Confront Rise In C. Diff Cases

California's acute care facilities are continuing to make inroads against hospital-acquired infections but are still being challenged by at least one type of superbug, according to new data from the tate Department of Public Health (CDPH).

That would be Clostridium difficile, or C. diff., a bacterial infection that usually originates in the digestive tract, typically due to the use of antibiotics. 

There were about 500,000 cases in U.S. hospitals in 2011. About 29,000 patients died within 30 days of receiving their diagnosis.

According to the CDPH, the rate of C. diff. Infections rose by 9% between 2011 and 2014, the last year for which data was available.

That was the only hospital-acquired infection whose presence grew in California's hospitals, many of which reported dramatic improvements in other areas.

For example, the incidents of central-line associated bloodstream infections have dropped 49% since 2008, according to CDPH data, with a total of 2,809 reported to the CDPH by 419 hospitals. Dozens of hospitals reported no such infections at all, although the rate of infections rose slightly at major academic medical centers, according to the CDPH.

Much of that reduction has been credited to Johns Hopkins physician and professor Peter Pronovost, M.D., who created a multi-step checklist for inserting central lines into patients. If the list is followed, the chance of a central line infection is nearly zero, studies have shown.

Only one hospital, City of Hope in Duarte, reported more than 100 central line infections. Its 117 infections reported was still a drop from 121 reported in 2013.

Surgical site infections have also decreased substantially, dropping 40% since 2008 to 4,316 last year.

Altogether, the state’s acute care facilities reported 19,200 hospital-acquired infections.

“This report will help the public make informed decisions on where they want to receive health care,” said CDPH Director Karen Smith, M.D. “Though data shows California hospitals are getting better, there is still work to be done.”

That is where the C. Diff rates come to the fore. Some of California's biggest teaching hospitals have seen significant increases in the rate of infections. 

Ronald Reagan UCLA Medical Center in Los Angeles saw rates of the infection climb 17% from 2013 to 2014, to 155 to 184 cases. Given the size of the hospital and the acuity of its patients, it was projected to have 115 cases in 2014. A statement issued by the hospital said its C. Diff infection rate dropped by more than 19% during the 2015 calendar year.

UC Irvine Medical Center in Orange saw the number of C. Diff cases climb from 118 cases in 2013 to 140 in 2014, an increase of 20%.

However, other large hospitals were able to reduce their cases. 

At UC San Francisco Health, the numbers dropped to 187 in 2014 compared to 203 in 2013. Cedars-Sinai Medical Center in Los Angeles saw its case volume drop to 307 in 2014 compared to 334 in 2013. However, that number remains significantly higher than its projected 2014 case volume of 307. Officials at Cedars-Sinai did not immediately respond to a request seeking comment.

The CDPH also released this week data on healthcare personnel who received influenza vaccinations during the 2014-15 flu season.

Altogether, 85% of hospital employees received their flu shots, while 66% of contracted employees were vaccinated.