I recently had a friend approach my about C diff. This friend had not taken antibiotics, yet had classic C diff presentation requiring metronidazole therapy – and that is a lousy drug to have to take.
This NY Times article is worthwhile – for physicians and non-physicians alike – Stomach Bug Crystallizes an Antibiotic Threat
Despite the horrible title – C diff is an intestinal infection – not a "stomach bug", the article is quite good.
In the case of the Mitchell family, Mr. Mitchell had been taking antibiotics for another health problem, and the treatment apparently led to his C. difficile infection. Mrs. Mitchell probably contracted the illness from her husband. The spores from C. difficile are hardy, and contaminated surfaces must be scrubbed down with bleach to eradicate the germ. Doctors say Mrs. Mitchell’s illness is unusual because most people are protected by their own bacterial flora and wouldn’t be vulnerable to C. difficile if they had not been taking antibiotics, even after close exposure. The risk of contracting C. difficile outside the health care setting remains low, at about 7 cases per 100,000 people, studies show.
C. difficile is not a new illness, but it appears to be spreading at an alarming rate. The rate of C. difficile infection among hospital patients doubled from 2001 to 2005, according to an April 2008 report from the C.D.C. The rise in C. difficile cases around the world is linked with the growing use of all antibiotics, particularly a class of drugs called fluoroquinolones, which came into widespread use around 2001. The use of acid-suppressing drugs, including proton pump inhibitors like Prilosec, also may be a risk factor, although studies have been contradictory.
End, public service announcement
{ 4 comments… read them below or add one }
thanks for posting this. i myself came down with what an ID doc said was probably C. Diff last year after a course of antibiotics and proton pump inhibitors left me susceptible. it was terrible! i was 26 and in good shape until then. let me just say that metronidazole is the worst drug i’ve ever taken.
Thanks for your interesting article. I am an emergency medicine resident and a clinical researcher currently doing a PhD, whilst this topic is outside my field of research I am interested in it. I was at a medical conference recently where a microbiologist from Perth provided a very interesting talk on this topic. He added something very interesting to the mix of “reasons that we could be facing difficulties with resistant strains of C difficile”.
Certain resistant strains of this organism may in fact be due to what is called “zoonosis” or spread of infections from animal to human – eg from pigs to humans. There has been an increase in incidence of C difficile infection in pigs and other farmed animals in the last decade and is more than likely connected with the practice of “therapeutic antibiotic” administration.
When I asked what they actually meant by “therapeutic” the speaker was also not that clear because it seemed that nobody is very clear about this practice, despite it’s widespread nature. It appears that animals are being injected with antibiotics in the hope that they will subsequently yield more meat when it comes to their slaughter. Previously antibiotics were being given to animals in the feed but this was banned in some countries, and now they can be given antibiotics only by Veterinarian doctors upon request.
It all sound a little fishy to me and I raised my concerns at the conference during discussion period. Basically this practice of giving animals inappropriate antibiotics (at least in my mind) may be having bad effects on not just animals health but humans health, and probably due to misunderstanding of the ill effects of the practice. Apparently the livestock industry is one of the biggest consumers of antibiotics in the market -so not surprisingly this is also big business for some parts of the pharmaceutical industry
Just some food for thought – I’d be interested to hear peoples comments
Cheers
bishan
Every time I read about this I am grateful that we got through a BMT without picking this up!
It was all outpatient, which was a little un-nerving, but I think the uncertaintly of feeling like I was responsible for someone with no immunity paid off in that we avoided a lot of exposure. Probably that spray bottle of bleach didn’t hurt either.
If someone has C-Diff does that also mean they are considered to have a compromised immune system?