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Deadly Hospital Superbug on Rise As Lothian Cases Soar By More Than 13 Per Cent

Posted on: Thursday, 28 July 2005, 09:01 CDT

A HOSPITAL superbug said to be more deadly than MRSA is infecting a growing number of people in Lothian.

The region's total number of cases of clostridium difficile - known as CD - rose from 137.5 per 100,000 population in 2003 to 156 per 100,000 in last year - an increase of more than 13 per cent.

That means the incidence of CD in the Lothians area was almost twice the Scottish average of 81.8 per 100,000.

Only Forth Valley health board recorded a higher rate of cases.

Separate statistics released in a parliamentary written answer to Nationalist MSP Stewart Stevenson show CD is now causing more deaths than MRSA.

And today he called for more research into the infection and claimed the growth of the superbug once again raised questions about the privatisation of hospital cleaning.

CD is a stomach infection which can lead to diarrhoea and severe inflammation of the bowel. It affects mainly elderly people and can be passed from patient to patient but is often sparked by the use of antibiotics to treat another condition.

An inquiry has been ordered into an outbreak of CD at Stoke Mandeville hospital in Buckinghamshire which has infected 300 patients and caused 12 deaths.

Dr John Cowden, consultant in health protection with NHS agency Health Protection Scotland, said the problem of CD was being addressed urgently.

But he said the strain of the bug which had caused the Stoke Mandeville outbreak, clostridium difficile 027, had not been detected north of the Border.

CD was mentioned as a cause of death on 206 death certificates in Scotland last year, a 48 per cent rise since 2001. That compares with 188 death certificates which mentioned MRSA, a 38 per cent rise since 2001.

Dr Cowden said about three per cent of the population carried CD with no ill effects.

Mr Stevenson said it was disappointing deaths from CD and MRSA were both on the rise. "Scotland should be taking the lead in investing in research," he said.

And he called for renewed emphasis on cleanliness in hospitals, saying privatisation of the service was "not helpful".

The Royal College of Nursing said international research had shown having an inadequate number of nurses posed a threat to patient safety and quality of care.

Maggie White, RCN Scotland deputy director, said: "Having too few nurses leads to a number of problems, including higher rates of infection amongst patients and ultimately more patient deaths.

"However, it's not just about having the right numbers. Many NHS staff aren't given sufficient uniforms to allow a clean uniform per shift. Many don't have access to changing and laundry facilities, forcing them to travel back and forward to work in their uniform. All this has to change if we want to seriously reduce the levels of Healthcare Acquired Infections (HAIs)."

Dr Alison McCallum, Lothian's director of public health, said CD was closely monitored in the region's hospitals, but the outbreaks experienced south of the Border had not happened here.

She said: "Patients who develop unexplained diarrhoea are isolated, tested and kept away from other patients until shown to be negative. In most cases the symptoms are mild and patients can be treated simply and effectively."

The Facts

CLOSTRIDIUM DIFFICILE causes a relatively mild illness in most cases, although it can result in serious illness and even death, particularly among elderly patients.

It is caused by antibiotics altering beneficial bacteria in the colon, allowing CD to flourish.

The bacterium produces two toxins which are responsible for diarrhoea and which damage the cells lining the bowel.

The infection is usually picked up in hospital, and almost all patients who develop CD are taking, or have recently been given, antibiotics.

More severe symptoms include diarrhoea that contains blood and mucus, and abdominal cramps. An abnormal heart rhythm may also occur.

In the majority of patients, the illness is mild and full recovery is usual, although elderly patients may become seriously ill with dehydration as a consequence of the diarrhoea.

The bacterium can form spores which can survive up to 70 days in the environment and can be transported on the hands of health staff.

Source: Evening News; Edinburgh (UK)

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