March 12, 2012
This blog post originally appeared on Pioneering Ideas: A discussion about breakthrough ideas in health and health care from the Pioneer Portfolio of the Robert Wood Johnson Foundation. The post covers research from Extending the Cure, a CDDEP project that examines policy solutions to address antibiotic resistance in the United States.
New Data Reveals High Death Rates From Clostridium Difficile (C. diff)
A new Vital Signs report issued March 6 by the Centers for Disease Control and Prevention shows rates of infection with Clostridium difficile (C. diff) are at historic highs and must be curtailed. C. diff can cause cramps, severe diarrhea and, in some cases, death.
Also on March 6, Extending the Cure a project funded by the Pioneer Portfolio that studies antibiotic resistance released a new analysis showing high C. diff death rates in parts of New England. In fact, the Extending the Cure analysis shows that as of 2007 Rhode Island, Maine, and Connecticut had the highest death rates for C. diff in the nation.
These top three states had death rates that were more than double the national average of 2.15 deaths per 100,000 people. The trend is visualized using the interactive mapping platform of ResistanceMap, Extending the Cure s online tool that tracks antibiotic use and drug resistance in North America and in Europe.
At the same time, the map shows that most Southern and Western states had death rates from C. diff that were below the national average. For example, Georgia, Colorado, and Idaho reported less than one death per 100,000 people from these infections in 2007. The geographical variation points to the need for additional research to better understand the epidemiology of C. diff infections and highlight the most effective ways of preventing their spread, says Ramanan Laxminarayan, director of Extending the Cure, the D.C-based research project funded in part by the Robert Wood Johnson Foundation s Pioneer Portfolio.
While C. diff has long been linked to hospitals, the CDC report finds that patients can acquire the infection in all medical settings, including nursing homes and outpatient clinics. Those most at risk are patients who take antibiotics, which can wipe out the good bacteria living in the gut, allowing C. diff to thrive.
C. diff infections can be reduced by judicious use of antibiotics, according to the CDC, which notes that about 50 percent of all antibiotics prescribed are not necessary. Reducing unnecessary antibiotic use will not only help prevent C. diff infections, but also curtail the growing problem of antibiotic resistance.
Addressing the rising rates of C. diff infections will require a multifaceted approach. In addition to promoting antibiotic stewardship, health officials must work towards better infection control and early diagnosis at hospitals and other facilities where C. diff and other health care-associated infections can spread from patient to patient or from one facility to the next.
In addition, policymakers, researchers, and others can use visualizations, like the map from Extending the Cure, to identify regions of the country with the most serious problems and look for targeted solutions to the rising tide of C. diff and other disease-causing bacterial pathogens.
Check out the new data and let us know what you think: Do you have a story to tell about a solution to the problem with C. diff?
Follow @ExtendgtheCure on Twitter to track coverage of this study.
Image credit: Flickr: SuperL
