Cost of C.difficile quantified

Clostridium difficile infection remains costly to the NHS and dangerous for patients, a European conference will hear today.

One analysis concludes that within Scotland the impact of the infection is equivalent to a 30-bed hospital ward being occupied for a full year.

A second analysis reported to the conference highlights the increased mortality rates faced by infected patients.

The problem is to be studied at the conference of the European Congress of Clinical Microbiology and Infectious Diseases in Vienna, Austria.

Professor Alistair Leanord, of Glasgow University, Scotland, will report on the costs of the 1,150 cases of infection in the country between October 2015 and 2016.

The average cost was £7,500 a patient compared with £2,800 for other patients – leading to a total cost of £8.65 million to the NHS.

A further analysis found that patients faced a doubled risk of dying within two months of admission compared with other patients. Some 29% died within this period.

The findings came from an analysis of 3,304 infected patients between 2010 and 2013 compared with 9,516 controls.

Microbiologist Dr David Enoch, of Public Health England, Cambridge, is to report similar findings.

He studied the fate of 6,874 patients who acquired the infection in hospital between 2002 and 2013 and had an average age of 77.

Out of these, 1,141 suffered recurrent infection and 49% of these died within a year compared with 38% of those who suffered only initial infection. They also suffered a slightly higher rate of other complications such as malnourishment and bowel perforation, he reports.

Dr Enoch said: "Cases in the UK have been coming down since 2008, which is most probably due to improvements in antibiotic prescribing and cleaning regimens in hospitals. This is encouraging but more still needs to be done.

“The main risk factor for developing C. difficile infection is prior antibiotic use. These patients are often already ill from some other underlying illness, which explains why they needed antibiotics in the first place.

"Older people are at greater risk of C. difficile infection as they are often sicker, have other illnesses or conditions, and so need more antibiotics."

He adds: "Strict adherence to antibiotic guidelines by clinicians and thorough cleaning of the hospital environment are crucial in ensuring that patients don’t develop C. difficile infection in the first place. Treatment with a new drug called fidaxomicin has also been shown to reduce the risk of recurrence in patients who are unfortunate enough to develop an infection.

"However, we still have a lot to learn, particularly about how C. difficile infection occurs in the community, and how best to treat it.”

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