THE PREVALENCE of Clostridium difficile, a potentially life- threatening healthcare-associated infection, may be higher in Irish hospitals than previously thought, according to new research.
A study at Dublin’s Beaumont Hospital, which looked at prevalence of the infection on one medical and one surgical ward over a six-week period, found 3.5 per cent of patients on the medical ward were infected, while prevalence rates in the surgical ward were at 1.1 per cent.
While infection rates can vary between hospitals, depending on their size and patient mix, the authors of the study point out that the prevalence of Clostridium difficilefound in this research "are higher than reported in previous Irish studies".
The research was carried out by Royal College of Surgeons in Ireland (RCSI) medical student Amanda Lavan and supervised by Dr Fidelma Fitzpatrick, a consultant microbiologist at Beaumont, who say the findings may indicate the prevalence of the infection is increasing.
Back in 2007 Minister for Health Mary Harney said she understood the overall incidence of the infection in Irish hospitals stood at 0.5 per cent. Dr Fitzpatrick said the finding that there was a higher prevalence of Clostridium difficileon the medical ward made sense as these patients tended to be in hospital for longer.
The bug causes a diarrhoea-type infection in vulnerable patients already on antibiotic therapy for other conditions. In severe cases it can cause death.
Beaumont's findings come one year after Clostridium difficilewas made a notifiable infection by Ms Harney. Since May 4th, 2008 hospitals have been required to report these infections to the national Health Protection Surveillance Centre (HPSC). More than 2,300 cases of Clostridium difficilehave been reported during the first year of the surveillance programme.
Among these cases were more than 60 patients who became infected during an outbreak of Clostridium difficileat Beaumont between July and October last year. The outbreak was linked to the deaths of three patients and was a contributory factor in the deaths of a number of others. Half the cases of Clostridium difficilerecorded over the period at Beaumont were of the virulent and highly transmissible 027 strain. Dr Fitzpatrick said Beaumont now had control over the problem.
The prevalence of MRSA, another healthcare-associated infection, among patients on one medical and one surgical ward was also measured over the six-week period of the Beaumont study. Some 20.4 per cent of patients on the medical ward and 12.2 per cent of patients on the surgical ward were colonised with MRSA. This infection can prove fatal if it gets into the bloodstream.
The high level of MRSA colonisation highlights the difficulties posed in maintaining proper isolation procedures at a large tertiary referral hospital like Beaumont, the study states.
Meanwhile, another study at Beaumont has found that a type of Clostridium difficilepreviously found only in young people and mainly in the community is now also found in older people and in hospital and healthcare settings. This 078 type can be associated with severe disease, Dr Fitzpatrick explained.
She said the hospital was sending its samples to a British laboratory for typing as there is no Clostridium difficilereference laboratory in the State, something that has been recommended but not yet acted on.