‘Super Bug’ causes alarm in the U.S.
CDC urges doctors to limit use of antibiotics
A seemingly undetectable "super bug" is responsible for infecting nearly half a million Americans in one year, according to a report released this week by the Center for Disease Control and Prevention (CDC).
The CDC found that in 2011 approximately 29,000 patients died within a month of contracting the illness and more than 15,000 deaths a year were a direct result of the bacteria, which can be contracted following a routine visit to the doctor or dentist.
Clostridium Difficile or C. Diff, is usually acquired in hospitals, but the new research from the CDC suggests that a growing number of patients are being exposed in other healthcare settings. Of the nearly half a million patients who contracted the illness, 33 percent had gone to a doctor or dentist’s office before being diagnosed.
The CDC responded this week by urging health care professionals to limit their prescription of antibiotics to patients.
The individuals who are at highest risk of developing a C. Diff infection are those who are taking or those who have recently finished taking antibiotics.
But while more than half of all hospitalized patients are treated with antibiotics, studies show that 30 to 50 percent of these prescriptions are unnecessary, according to the CDC.
The C. Diff bacteria is especially dangerous because it can be contracted and eventually manifested in the intestines during the treatment of an un-related illness, said Dr Michael Lichtenstein, a professor of medicine at the University of Texas Health Science Center at San Antonio, who was not involved in the study.
C Diff. is known to reside in the intestines where it can flourish, if triggered. Antibiotics, which are the usual treatment for many infections, strip the intestines of so-called good bacteria, which are necessary to maintain intestinal balance and can potentially fight off bacterial infections, the CDC said.
When an imbalance does occur, C. Diff bacteria wreak havoc in the colon, resulting in severe diarrhea and, in some cases, toxic damage to the intestines, according to the CDC.
CDC officials say severe cases of C. Diff can cause holes in the intestine, which can be life-threatening if bacteria are able to enter into the bloodstream. To prevent sepsis, a blood infection, doctors must surgically remove the damaged portion of the colon.
“Clostridium difficile has always been there. I think the awareness is much greater [now] because of an over use of antibiotics and the increased number of cases,” said Dr. Michael Lichtenstein.
“I had a patient who developed documented Clostridium difficile after a single dose of antibiotics in anticipation of a routine dental cleaning procedure. Fortunately, they responded quickly to first line treatment.
“So patients and their health care teams need to be vigilant about the need for any medication that will upset the balance of the bacteria that live inside us,” Dr. Lichtenstein added.
The most common way to combat a C. Diff infection is through antibiotics, according to the CDC. This treatment can potentially cause a recurrence of the illness since the antibiotics keep good bacteria from restoring a healthy balance in the intestines, explained the CDC’s Dr Michael Bell.
In fact, the CDC study found that one in five patients who contracted C. Diff experienced another bout of infection after treatment.
The fear with this particular bacterium is that it is resistant to hand gel sanitizers and allows it to survive on a variety of surfaces, including healthcare equipment, furniture, and linens - hence its super-bug title, explained Dr Michael Bell, CDC Director of Health Care Quality and Promotion.
CDC officials this week reiterated the importance of doctors using gloves and other personal protective equipment while examining patients to reduce the risk of infection.
Additionally, washing hands regularly with soap and water is another measure that can prevent the transmission of bacteria to others.
“This is a tough infectious disease to treat,” said Dr Lichtenstein. “It’s especially difficult to manage in long–term care settings, like nursing homes, where the risk of spreading to other frail older adults is high.
“One way to manage the condition, with a long slow taper of antibiotics effective against Clostridium Difficile requires a lot of patience,” he added.
Dr Lichtenstein urged against the over-prescribing of antibiotics by doctors in the U.S.. Antibiotics are often seen as a quick fix for many routine ailments, but the proper management of antibiotics is key to reducing C. Diff infections.
Patients also play a vital role in preventing C. Diff infections. Dr. Lichtenstein cautions patients from pressuring their doctors into prescribing them antibiotics, especially in the case of viral illnesses.