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Spread Seen in Antibiotic-Resistant Bacterial Illness

Posted on: Sunday, 4 December 2005, 09:00 CST

By Mike Stobbe

A deadly bacterial illness commonly seen in people on antibiotics appears to be growing more common -- even in patients not taking such drugs, according to a report published Thursday in a federal health journal.

In another article in the New England Journal of Medicine, health officials said samples of the same bacterium taken from eight U.S. hospitals show that it is mutating to become even more resistant to antibiotics.

"I don't want to scare people away from using antibiotics. . . . But it's concerning, and we need to respond," said Dr. L. Clifford McDonald, an epidemiologist at the federal Centers for Disease Control and Prevention, and an author of both articles.

"Hospitals need to be conducting surveillance and implementing control measures. And all of us need to realize the risk of antibiotic use may be increasing [as the bacteria continue to mutate]."

The bacterium is Clostridium difficile, also known as C-diff. The germ is becoming a regular menace in hospitals and nursing homes, and last year it was blamed for 100 deaths over 18 months at a hospital in Quebec.

"What exactly has made C-diff act up right now, we don't know," McDonald said.

The article published in the agency's Morbidity and Mortality Weekly Report focuses on cases involving 33 otherwise healthy people that were reported since 2003 in Pennsylvania, Ohio, New Jersey and New Hampshire.

Most of the 33 had not been in a hospital within three months of getting sick, and eight said that they had not taken any antibiotics in that span.

C-diff is found in the colon and can cause diarrhea and a more serious intestinal condition known as colitis. It is spread by spores in feces.

The spores are difficult to kill with most conventional household cleaners. Even washing your hands with an antibacterial soap does not eliminate all the germs.

C-diff has grown resistant to certain antibiotics that work against other colon bacteria. The result: When patients take those antibiotics, particularly clindamycin, competing bacteria die off and C-diff spreads. One of the 33 patients in the report died -- a Pennsylvania woman, 31, who was 14 weeks pregnant with twins when she first went to the emergency room with symptoms. Despite treatment with antibiotics considered effective against C-diff, she lost the fetuses and then died.

Doctors watching for C-diff in hospitals and nursing home patients need to look for it in other patients as well, McDonald said.

Patients need to be wary, too. "If you have severe diarrhea," he said, "seek attention from a physician."

Source: Buffalo News

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