The C. difficile outbreaks since 2006 are likely to have been triggered by overuse of antibiotics, according to an analysis published today.
Cases of C. difficile fell only when antibiotics called fluoroquinolones were restricted and used in a more targeted way, say the team from the Universities of Oxford and Leeds, and Public Health England.
These antibiotics, which include the widely-used ciprofloxacin, were used inappropriately, allowing C. difficile bugs that were resistant to the drug to thrive, say Professor Derrick Crook and colleagues in The Lancet Infectious Diseases.
"The restriction of fluoroquinolones resulted in the disappearance in the vast majority of cases of the infections caused by the antibiotic-resistant C. difficile, leading to around an 80% fall in the number of these infections in the UK," they write.
For example, in Oxfordshire about 67% of C. difficile bugs were antibiotic-resistant in September 2006, compared to only 3% in February 2013.
Rates of C. difficile bugs that were not resistant to fluoroquinolone antibiotics stayed the same, and were unaffected when it was restricted.
The team also found that comprehensive infection prevention and control measures, like better handwashing and hospital cleaning, failed to cut the number of bugs transmitted between hospital patients.
"Alarming increases in UK hospital infections and fatalities caused by C. difficile made headline news during the mid-2000s and led to accusations of serious failings in infection control," says Professor Crook.
"Our study shows that reducing the type of antibiotics like ciprofloxacin was the best way of stopping this national epidemic of C. difficile and routine, expensive deep cleaning was unnecessary. However it is important that good hand hygiene continues to be practiced to control the spread of other infections."
* Guidance from the National Institute for Health and Care Excellence today says that children and young people should be taught "simple hygiene" to prevent the spread of infections – from nursery to university.
And students leaving home for the first time should get information about how to care for themselves when they get infections such as the common cold.
The guidance also calls for increased public awareness of when antimicrobial medicines are needed.
Crook, D. et al. The Lancet Infectious Diseases 25 January 2017. [abstract]
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