Some Thoughts About C. Diff And "Superbugs"

[tex]

Hi All,

I suppose that I should be worried about the economy, hurricanes and other severe weather events, terrorists and wars, and various other things that everybody else worries about. I'm not really concerned about those, though, because there's really not much that I can do about any of them. I do worry about the so-called "superbugs" that are rapidly becoming a serious threat to all of us, though. I'm not sure that I can do anything about them either, but I can damn sure try to keep 'em out of my body, and the only way to do that is to be constantly vigilant.

One of the most dangerous and virulent foes that we have in the war against antibiotic "superbugs" is Clostridium difficile, (C. diff for short). On the 17th of this month, the Wall Street Journal published an article on the rapidly rising risk that C. diff is imposing on our health system, and much of what I have written in this post is based on information in that article, plus some other facts that I've been mulling over for some time now.

C. diff has been around for a long time, but it seems to have "shifted gears", and it's rather rapidly becoming somewhat of an epidemic, in hospitals, nursing homes, and other medical institutions all over the world. It can cause severe diarrhea, ruptured colons, perforated bowels, kidney failure, blood poisoning and death, mostly due to a recent, more virulent strain of the bug that tends to cause more severe complications. In fact, The Centers for Disease Control and Prevention estimates that there are now approximately 500,000 cases of C. diff infection each year in the U.S. alone, contributing to between 15,000 and 30,000 deaths. That's more than three times the number of cases treated just a few years ago, (in 2001, there were only about 150,000 cases).

C. diff was first identified in the 1970s, and it was comparatively easy to treat, back then. The more dangerous strain that is posing the current problems, was first identified in the year 2000, and that year it killed 18 patients. Within four years, the new strain had spread to many areas in the U.S. and around the world, and the CDC began to spread the alarm about it's dangers. Studies show that it produces about 20 times more toxin than the older strains.

As we on this board are well aware, taking antibiotics is a major cause of C. diff infections, because when we take antibiotics, (especially broad-spectrum antibiotics), both bad and good bacteria in the gut are suppressed, which allows drug-resistant strains of C. diff to grow out of control, and take over the gut.

More and more hospitals are realizing that they have to clean up their act, especially now that medicare has served notice that the hospitals will not be reimbursed for infections that they themselves cause, (IOW, infections that originate during a hospital stay), so they're monitoring and limiting their use of antibiotics, much more carefully these days. That strategy also has helped in preventing the spread of other drug-resistant bacteria. Still, there are a lot of doctors who haven't yet come to grips with the situation, and they are writing a lot prescriptions that probably shouldn't be written, at least not for certain classes of antibiotics.

One of the greatest risks with C. diff is due to the fact that it produces spores that can dry out, even after cleaning, and it can survive on hospital cart handles, bed rails, telephones, doorknobs, etc., for months. The alcohol-based cleaning solutions that many hospitals use in an effort to try to prevent C. diff from spreading, can actually help disperse C. diff spores. Instead of alcohol, they need to use antibacterial solutions and soap, and many hospitals are now beginning to require their staff to wash their hands with antibacterial soap when dealing with C. diff patients.

Note that anti-bacterial towelettes, wipes, etc., that contain at least 0.1% benzethonium chloride as an active ingredient, are definitely effective against C. diff. In fact, benzethonium chloride exhibits a broad spectrum of microbiocidal activity against bacteria, fungi, mold and viruses. Independent tests show that it is highly effective against such pathogens as: MRSA, VISA, Salmonella, E. coli, C.diff, Hepatitis B and C, Herpes, HIV, RSV, and Norovirus. It's available for sale under the trade names salanine, BZT, diapp, quatrachlor, polymine d, phemithyn, antiseptol, disilyn, phermerol, and others. Note that MRSA is another so-called "superbug" that is known as the "flesh-eating" bacterium, (it attacks the skin and is so aggressive that amputation of a limb is sometimes necessary, in order to save the patient's life.

As an example, the "Wet Ones" Antibacterial Hands and Face Wipes that I keep handy in my vehicles, and use without fail after every visit to any hospital, clinic, doctor's office, or for that matter - any public place, contains the active ingredient benzethonium chloride, in the amount of 0.3%, which should be quite effective, (hopefully).

About 3% to 5% of healthy adults in the general population, carry C. diff in their gut, but in hospitals and nursing homes, where carriers can spread the bacteria to others, studies in recent years have shown that 20% or more of inpatients are colonized with C. diff, and one recent study of 73 long-term-care residents showed that 55% tested positive for C. diff. Even though most of them had no symptoms of the disease, spores on the skin of these asymptomatic patients were easily transferred to the investigators' hands.

If you are interested in more details, the WSJ article contains a lot of personal stories of patients who barely escaped with their lives, after a bout with C. diff, and some who were not as fortunate, and didn't survive. It will definitely get your attention. The story is in the September 17th, 2008 issue.

This is getting to be so long, that I think I'll save a discussion on "superbugs" in general, for another topic.

The bottom line is: Please don't let your doctor talk you into a broad-spectrum antibiotic, (of the type that we know carries a bad history of causing C. diff), unless you are sure that you absolutely need it, and your doctor is sure that no other, (more specific), antibiotic will do the job. If you do end up taking an antibiotic, please make every effort to stay away from anyone and any place, known to be a source of C. diff infection. Get some antibacterial products that are known to be effective against these bacteria, and use them often - especially after visiting any place where you might be at risk of encountering these pathogens. In fact, use those antibacterial products regularly, even if you never take any antibiotics. At one time, C. diff was considered a risk for older people. Now, though, with the new strains of C. diff, each and every one of us in the general population is at risk, and those of us with compromised immune systems, (which is everyone who is a member of this board), have a much greater risk, obviously.

Tex

[Gloria]

Very scary, Tex. Thank you for reminding us to be fastidious about using antibacterial agents after being in high-risk areas.

My mother lived in a nursing home for 18 years. She had MRSA, most likely due to having a feeding tube, and she never was able to get rid of the infection. Nursing homes are required to report all cases and must treat them with antibiotics. As a result, she was constantly on antibiotics, which also caused D. It was a viscious cycle. Just before she died, she had pneumonia and the MRSA was in her sputnum. She had to wear a mask because she was coughing with the MRSA. She'd keep pulling the mask off. I had pneumonia at the same time and was extremely nervous when I visited her. It was a living nightmare.

Gloria

[tex]

Gloria,

I'm so sorry to read such a sad story, but I appreciate your posting it. That truly was a living nightmare, and I'm so glad that you were able to avoid the infection.

Nervous? I'd be scared to death in a situation like that, and I suspect that anyone in their right mind would be.

Tex

[annie oakley]

Thank you very much for the post, It is extremly scarey. But it sure makes you aware.
Love Oma