Hospitals Struggling With C. Diff Control

Hospitals in California and elsewhere are taking more steps to combat potentially deadly infections of Clostridium difficile among its patients, but are being mostly thwarted in their attempts to curb new cases.

The bacterial infection, known in healthcare as C. diff, is typically hospital-acquired and kills about 14,000 patients nationwide every year. In California, there were more than 13,300 such infections reported by hospitals between March 2010 and March 2011, according to data they submitted to the Office of Statewide Health Planning and Development.

A new survey of more than 1,000 infection control professionals by the Association for Professionals in Infection Control and Epidemiology has concluded that hospitals have been ramping up their efforts to fight outbreaks of C. diff, but that they are mostly struggling with keeping the infection in check.

According to the survey, 70% of respondents said they have taken additional measures to combat C. diff in their hospitals over the past three years, and 65% said that best practices for fighting such infections are in place – primarily specific rules about handwashing after patient contact and other cleaning and environmental practices. However, only 42% say they have seen rates of infection decline. Moreover, 43% of respondents say there has been no decline in the infection rate at all.

“We are encouraged that many institutions have adopted stronger measures to prevent (C. diff), but as our survey indicates, more needs to be done to reduce the spread of this infection,” said Jennie Mayfield, president-elect of APIC and a clinical epidemiologist at Barnes Jewish Hospital in St. Louis.

Mayfield noted that although 92% of respondents said they have increased emphasis on environmental and equipment cleaning, 64% say they rely on observation to promote such practices, rather than using fluorescing or other products to guarantee it is occurring.

“Because C. diff. spores can survive in the environment for many months, environmental cleaning and disinfection are critical to prevent the transmission of CDI,” Mayfield said. “(Hospital) environmental services must take the lead in developing aggressive programs to monitor cleaning practices and then ensure that the results are shared with frontline staff. Without that buy-in, practices are unlikely to improve.”