As we reported earlier this week, a new strain of Clostridium difficile (CD), a common bacterium, has become quite virulent and deadly. At Stoke Mandeville Hospital in Buckinghamshire (UK), twelve patients have died and another 300 have been infected with CD since 2003. In the UK alone, there were 43,682 cases of CD reported in 2004 and 934 CD-related deaths in 2003.
CD is an infection (discovered in 1935 as a bacteria and in 1978 as a disease) which, in its common form, mainly affects the elderly and causes severe diarrhea and colon inflammation. The new strain of CD however affects younger patients as well and is far more problematic and even fatal if antibiotic treatment is unsuccessful. CD bacteria are naturally present in the intestine and are kept under control by other bacteria. When antibiotics kill some of the controlling bacteria, however, CD can take hold and spread. The strain that has appeared in the UK is related to one which has already emerged in the U.S. and Canada. It is difficult to eradicate in a hospital setting and, as a result, is easily spread from patient to patient. CD is not destroyed by antibiotic hand gels.
In Canada, CD has killed 189 patients in the past 18 months, 100 of those in one Quebec hospital alone. The disease has been confined to several hospitals in Quebec and Calgary. CD is also a problem in the U.S. and has been the subject of several studies and journal reports. It is high on the priority list of the Centers of Disease Control and Prevention in terms of controlling and monitoring.
Now, in the UK, it is being reported, that detergents used to clean hospital wards are actually making this deadly strain of CD worse. The detergents, which are basically soap and water, cannot penetrate the tough outer wall of the CD spores. Moreover, it appears that the detergents actually encourage CD to produce more spores.
Bleached-based cleaners, which are not generally used in hospitals because they tend to rot surfaces, are known to kill CD spores. Stoke Mandeville Hospital is now using bleach in areas known to have CD. The number of CD infections has been dropping each month since the protocol was instituted.