How difficile can it be? Microbes under UV

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  • Published: May 1, 2015
  • Author: David Bradley
  • Channels: UV/Vis Spectroscopy
thumbnail image: How difficile can it be? Microbes under UV


C. difficile bacteria glowing under UV light « Are Hospitals Doing All They Can to Prevent C. diff Infections? Not Yet, New Study Suggests (Credit: Centers for Disease Control and Prevention)

The bacterium Clostridium difficile (pictured under longwave ultraviolet light) kills almost 30000 people annually in the US and causes sickness in hundreds of thousands more. A new study reveals that close to half of American hospitals are not taking simple, but critical, steps to prevent its spread despite strong evidence of efficacy of such actions.

In research published in the online edition of Infection Control & Hospital Epidemiology a team from the University of Michigan Medical School and VA Ann Arbor Healthcare System says that almost all of the 398 hospitals examined in a random sample of hospitals nationwide have some C diff protection measures in place. Unfortunately, almost half of them (48 percent) have not adopted recommended strict controls - antimicrobial stewardship programs - on the prescription of antibiotics and other drugs that can allow the dangerous bug to flourish. Many hospital patients are especially prone to developing C. diff infections if they are on antibiotics and other medication that can disrupt the balance of intestinal bacteria as this microbe will take opportunistic advantage of the newly vacated niche.

Most of the hospitals had programs to monitor for C. diff infections, and use protective gear, separate hospital rooms and special cleaning techniques when dealing with infected patients to prevent the bacterium spreading to others. C. diff can lie dormant for weeks in a spore form that persists in the hospital environment.


The team also saw that almost three quarters of the hospitals did not have written policies on patient testing when patients present with diarrhoea while taking antibiotics, despite diarrhoea being a common symptom of C. diff infection.

C. diff infection over the last decade has emerged as a threat to patients, especially the most vulnerable and the elderly, and has increased in incidence and severity,” explains lead author of the study Sanjay Saint. “There are many ways to try to limit the spread, and from our data it looks like hospitals are aware of the evidence behind them and acting on many where they believe the evidence is strong,” he continues. “But the one area where there’s a major disconnect between evidence and practice is antimicrobial stewardship, or limiting antibiotics to use only when necessary. This is a real opportunity for improvement.”


Saint and colleagues in the Patient Safety Enhancement Program, a joint U-M and VA program, surveyed infection control leaders at hospitals, as part of an ongoing study that began in 2005. The study is funded by the Blue Cross Blue Shield of Michigan Foundation and by a Patient Safety Center of Inquiry grant from the Veterans Affairs National Center for Patient Safety. They point out that more than 60 percent of hospitalized patients are prescribed antibiotics at some point, but half of those prescriptions are thought to not be necessary. Saint suggests that reducing antibiotic overuse in hospitals would not only reduce the risk of opportunistic C. diff infection but also reduce the risk of emergent antibiotic resistance in this and other putative “superbugs”.

“The doctors who prescribe most of these antibiotics, and who would have to buy in to stewardship programs, are hospitalists,” says Saint. “Nationally, they’re the ones we must engage with to overcome this disconnect between what people think works and what they’re actually doing, and to implement stewardship programs. This is about changing physician behaviour and that makes it more challenging.”

Related Links

Infect Control Hospital Epidemiol 2015, online: "Clostridium Difficile Infection in the United States: A National Study Assessing Preventive Practices Used and Perceptions of Practice Evidence"

Article by David Bradley

The views represented in this article are solely those of the author and do not necessarily represent those of John Wiley and Sons, Ltd.

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