Scotland’s health secretary has ordered an independent public inquiry into a fatal outbreak of Clostridium difficile at a Dunbartonshire hospital.

A total of 55 people at the Vale of Leven hospital were affected by the infection, and 18 patients died, between December 2007 and June 2008.

An initial review of procedures at the hospital found “inadequate” infection controls.

Full Article:  C.diff deaths inquiry announced

The definition of an “outbreak” was recently called into question, when a number of patients at St. Joseph’s Healthcare acquired c.difficile — but in a pattern which didn’t exactly match reporting guidelines.

This caused confusion within the hospital over whether to declare an outbreak situation, as well as highlighting the delay between an identified rise in infections, and when the public finds out about it.

Eventually, all outbreaks get reported in each hospital’s monthly filing on a public website set up by the Health Ministry. But it could be a month before the public hears about it, Baker acknowledges. Hundreds of patients and visitors could pass through a hospital in that time.

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One definition says an outbreak occurs when three or more new cases appear within seven days in one ward. It is also an outbreak when six or more cases occur within 30 days in a single ward or unit.

But at St. Joe’s, the current C. diff outbreak was not confined to one ward. Cases were spread through the hospital.  Chief of staff Dr. David Higgins says that made it difficult to establish whether St. Joe’s was in outbreak or simply faced a seasonal rise in C. diff.

“That’s why we agonized over this for several days,” says Higgins.

Full article: What makes it an oubreak?

Five seniors with C. difficile have died at St. Joseph’s Hospital in the last month.

That is nearly one in three of those who got the bacterial infection that causes severe diarrhea.
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C. diff is one of three outbreaks St. Joseph’s Healthcare is currently battling.

Another senior died during the first week of March from invasive Group A streptococcus, which was spreading on the geriatric psychiatry unit at the Centre for Mountain Health Services.

Three wards remain closed to visitors at the downtown hospital as St. Joseph’s tries to contain the Norwalk virus.

Full Article:  Three St. Joe’s patients die of C. diff since April 1

In a study funded by NIH, Harvard Medical School, and the Irish Health Research Board, researchers have found a method to accurately predict which patients will experience a recurrence of C.difficile infection:

The method correctly identified 77.3% of patients who had recurrent infection in a derivation cohort studied in 1998, according to Ciarán P. Kelly, M.D., of Harvard Medical School, and colleagues.

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C. difficile has become the leading cause of hospital-acquired infectious diarrhea. It affects millions of patients a year. Multiple recurrences are common, despite successful treatment of the initial episode

“This rule is valuable in clinical practice as it defines a high-risk population in whom awareness of the risk can facilitate more prompt recognition, diagnosis, and treatment of recurrent C. difficile,” Dr. Kelly said in a statement.

The rule combines three variables: age, disease severity, and antibiotic use.

Full article:  Clinical Rule Predicts C. Diff Recurrrence

>>March 21st

Simple techniques slash hospital infections: meeting

Jasper Palmer didn’t think he was doing anything special when he balled up his paper hospital gown and stuffed it into one of his gloves. He just knew it was tidy and would stop the gown from spreading germs.

But the technique is one of the simple innovations that has reduced rates of infection with so-called superbugs at his and other hospitals by 26 percent to 62 percent, infection control experts told a meeting of the Society for Healthcare Epidemiology of America in San Diego on Saturday.

>>March 23rd

Simple ideas from hospital staff cut superbug rates

Borrowing ideas from hospital workers who have devised their own clever strategies for reducing superbug spread can lead to huge drops in infection rates throughout a hospital, say infection control experts.

The experts told a meeting of the Society for Healthcare Epidemiology of America in San Diego on Saturday that using an approach called positive deviance (PD) at three U.S. hospitals helped to reduce the incidence of MRSA (multifaceted methicillin-resistant Staphylococcus aureus) at their facilities by 26 to 62 per cent.

>>March 25th

Northern Ireland scientists find a new weapon in MRSA war

A new weapon that could help wipe out the deadly MRSA virus has been developed by researchers from Northern Ireland.
Experts from Queen’s University have discovered new agents that can kill colonies of MRSA and other antiboitic resistant hospital-acquired infections.

The antimicrobial agents also prevent any growth of the potentially lethal bacteria.

C difficile outbreak leaves three hospital patients dead

Three patients have died as a direct result of a C difficile outbreak at hospital in the South East.

East Sussex Hospitals trust has recorded 62 cases of the infection at Eastbourne District General Hospital since 1 January and has reviewed the histories of the affected patients.

The trust said on Tuesday that three patients had died as a direct result of being infected and it had contributed to a further 10 deaths.

>>March 27th

‘Search and destroy’ kills MRSA

A private hospital in Dublin has instituted a strict ’search-and-destroy’ policy to combat MRSA infections.

See a video of Dr. Fidelma Fitzpatrick from the Irish Health Protection Surveillance Centre discuss the facts of healthcare-associated infections here.

‘Super’ C. difficile outbreak linked to deaths of 13 patients

The particularly virulent new strain of C. difficile responsible for the outbreak, known as 027, can produce 20 times as much toxin as others, is known to cause a higher mortality rate and is resistant to several drugs used to combat the infection.

>>Feb 28/09

Antibiotic resistance: The ongoing challenge for effective drug therapy
The Journal for the American Academy of Physician Assistants (JAAPA) posts the first in a series of three articles on antibiotic resistance that “reviews this serious health threat, explains why the challenge is never-ending, and offers possible solutions.”

>>Mar 4/09

A 76-Year-Old Man With Recurrent Clostridium difficile Associated Diarrhea
JAMA article takes an in-depth look at the management of c.difficile by following the case of Mr S — examining the difficulties in managing c.difficile treatment can complicate the management of other conditions.

>>Feb 25/09

Reducing bacterial contamination using silver antimicrobial technology
New study examines whether the use of silver-treated materials can help contain the spread of nosocomial infections.

>>Feb 26/09

High-tech innovations to combat MRSA and C. diff are unveiled
Modern methods for combating MRSA to be piloted in seven NHS hospitals.

Portable hand washing stations, infection resistant loos, and pop-up isolation rooms are among the new technologies hospitals will be introducing to combat MRSA and C. diff, ministers said.