Monday, March 22, 2010

More on CDIs

If there is a pathogenic face to antibiotic resistance, it's MRSA, or methicillin-resistant Staphylococcus aureus. It can be gross and gory, affects both the elderly in nursing homes and children on athletic teams, and causes more deaths in the U.S. each year than AIDS. But is it the infection you should be most worried about during a hospital stay?

New research suggests that Clostridium difficile infections (CDIs) may be overtaking MRSA as the most threatening of the antibiotic-resistant infections the American healthcare system faces. Scientists affiliated with Duke's Infection Control Outreach Network (DICON) presented a study at last weekend's Fifth Decennial International Conference on Healthcare- Associated Infections that found CDI rates in excess of MRSA infections in community hospitals in the Southeast United States. In this group of 30 hospitals, which were monitored from January 2008 through June 2009, C. difficle was the leading healthcare-associated infection (HAI). C. difficile beat out MRSA, 612 cases (0.26 per 1,000 patient-days) to 505 cases (0.22 per 1,000 patient-days).

Previous studies also suggest that the mortality rate for CDI is higher than MRSA. But it's also possible that CDI is more preventable, because it is so closely linked to previous antibiotic usage in each individual patient, and largely confined to healthcare settings (except in pediatrics - see "CDIs Increasing in Children" below). This is one case where effective infection control and prevention strategies, as well as public education, could go a long way. You can learn more about C. difficile from the CDC and the Mayo Clinic.

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