The seventh international conference of the Hospital Infection Society recently took place in Liverpool – covering topics ranging from infection control and epidemiology, to surveillance and decontamination. High on the agenda was the subject of C. difficile. LOUISE FRAMPTON reports.
Assuming the population of European Union to be 457 million, C. difficile infection can be estimated to cost the EU ?3 billion per annum.1 However, there are fears that this figure will significantly rise as the EU faces an ageing population. Some 60% of cases occur in patients above the age of 65 years old and, since this population is expected to double over the next 40 years, the costs associated with treating the infection are also predicted to double. New and more deadly strains of C. difficile are also presenting significant challenges to healthcare organisations across the EU, and this was a key topic of discussion at HIS 2010. Ed Kuijper, Center of Infectious Diseases, University Medical Center of Leiden, Netherlands, highlighted the importance of surveillance in tackling the threat posed by C. difficile. In particular, the EU became aware of a new, virulent strain (027), from 2002/2003, which was associated with a much higher mortality rate.
Complication rates were also found to be higher and the relapse rate in patients doubled. The first known case associated with the 027 strain was identified in Paris in 1988, but the increase in infections was not a gradual one. Outbreaks were suddenly reported across Canada, the US and Europe in 2002/2003; and, by 2008, 17 countries across Europe had reported outbreaks or endemic C. difficile infection. The most important factor, he pointed out, was antibiotic misuse. Ed Kuijper commented: “We believe the strain has undergone a change in the attack rate. When patients are colonised, it leads to earlier disease and the strain is less likely to result in a pattern of asymptomatic colonisation... The strain also produces more spores, which are thought to be more resistant to disinfectants and more difficult to eradicate from the environment.”
Surveillance
Log in or register FREE to read the rest
This story is Premium Content and is only available to registered users. Please log in at the top of the page to view the full text.
If you don't already have an account, please register with us completely free of charge.