SOURCES: Feb. 25, 2015, press conference with: Michael Bell, M.D., deputy director, division of healthcare quality promotion, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention; Marc Siegel, M.D., professor, medicine, NYU Langone Medical Center, New York City; Feb. 26, 2015, New England Journal of Medicine
WEDNESDAY, Feb. 25, 2015 (HealthDay News) -- Almost half a million Americans were infected with the bacteria Clostridium difficile in 2011, and 29,000 died within a month of diagnosis, U.S. health officials report.
"Infections with C. difficile have become increasingly common over the last few decades, and are seen in patients in health-care facilities as well as people in their communities," Dr. Michael Bell said at a U.S. Centers for Disease Control and Prevention press conference Wednesday.
C. difficile, which causes inflammation of the colon and deadly diarrhea, is often linked to antibiotic use, said Bell, deputy director of healthcare quality promotion at the CDC's National Center for Emerging and Zoonotic Infectious Diseases.
Antibiotics can destroy the natural bacterial balance in the colon, allowing C. difficile to take over, he explained.
These infections can be prevented by controlling use of antibiotics, and making sure health-care facilities use infection-control procedures when treating patients infected with C. difficile, Bell said. Such measures have resulted in a 10 percent drop in C. difficile infections since 2011, he added.
"If we can improve antibiotic prescribing, we expect to see rates of C. difficile infection improve dramatically," Bell said. This means taking antibiotics only when necessary and for as long as necessary, he explained.
Treatment of C. difficile involves antibiotics. However, even when the infection is cured, it is difficult to restore the colon's normal bacteria, which enables C. difficile to recur, Bell explained.
"One in five patients has at least one relapse that requires treatment," he said.
Although anyone can get C. difficile, the elderly are especially vulnerable.
"About 55 percent of health care-associated C. difficile infections and 80 percent of the deaths that occur because of it happen in people 65 years of age and older," Bell said.
Moreover, he added, "one out of nine patients over 65 years old with C. difficile infection dies within 30 days of diagnosis."
The report was published Feb. 26 in the New England Journal of Medicine.
Severe C. difficile infection can damage the colon, requiring surgery, Bell added.
In addition, C. difficile spreads easily. "It forms hard spores that can contaminate the environment," he said. These spores are not killed by antibacterial cleansers or hand sanitizers.
Bell said the best way to prevent transmission is to wash away the spores with soap and water, and for health-care workers treating infected patients to wear gloves.
For the report, researchers collected data on C. difficile infections in 10 areas of the United States in 2011. They wanted to know how many infections were related to health-care facilities, such as hospitals and nursing homes, and how many were contracted in the community at large.
Two-thirds of C. difficile infections occurred in hospitals and nursing homes, the investigators found. However, 150,000 infections were community-associated, meaning they happened among those who had not been inpatients in a health-care facility.
"About 80 percent of patients with community-associated C. difficile infection did have contact with health-care settings, like a doctor's office or a dental clinic, and most of those patients were also given antibiotics," Bell said.
The researchers estimated that there were 453,000 C. difficile infections in the United States that year. They calculated that women, whites and those aged 65 and older were most likely to be infected.
Moreover, the study authors estimated that 83,000 people experienced a first recurrence of C. difficile infection, and that 29,300 people died from the bacteria in 2011.
Dr. Marc Siegel, a professor of medicine at NYU Langone Medical Center in New York City, is concerned that C. difficile infections are increasing in the general community.
"The overuse of antibiotics and the improper use of sanitation in hospitals is causing these infections to move into the community," he said. "And that's predictable."
Siegel agreed that careful antibiotic prescribing and better infection control in health-care facilities are needed to curb infections and deaths from C. difficile.
For more about C. difficile, visit the U.S. Centers for Disease Control and Prevention.