C. difficile resistance and clindamycin

CDC: Deadly bacterial illness appears to be spreading


ATLANTA , Georgia (AP) -- A deadly bacterial illness commonly seen in
people
on antibiotics appears to be growing more common -- even in patients
not
taking such drugs, according to a report published Thursday in a
federal
health journal.


In another article in the New England Journal of Medicine, health
officials
said samples of the same bacterium taken from eight U.S. hospitals show
it
is mutating to become even more resistant to antibiotics.
"I don't want to scare people away from using antibiotics. ... But it's

concerning, and we need to respond," said Dr. L. Clifford McDonald, an
author of both articles and an epidemiologist at the federal Centers
for
Disease Control and Prevention.


"Hospitals need to be conducting surveillance and implementing control
measures. And all of us need to realize the risk of antibiotic use may
be
increasing" as the bacteria continue to mutate, McDonald said.


The bacterium is Clostridium difficile, also known as C-diff. The germ
is
becoming a regular menace in hospitals and nursing homes, and last year
it
was blamed for 100 deaths over 18 months at a hospital in Quebec,
Canada.


"What exactly has made C-diff act up right now, we don't know,"
McDonald
said.


The article published in the CDC's Morbidity and Mortality Weekly
Report
focused on cases involving 33 otherwise healthy people that were
reported
since 2003 in Pennsylvania, Ohio, New Jersey and New Hampshire.


Most of the 33 hadn't been in a hospital within three months of getting

sick, and eight said they hadn't taken any antibiotics in that span.


C-diff is found in the colon and can cause diarrhea and a more serious
intestinal condition known as colitis. It is spread by spores in feces.



The spores are difficult to kill with most conventional household
cleaners.
Even washing your hands with an antibacterial soap doesn't eliminate
all the
germs.


C-diff has grown resistant to certain antibiotics that work against
other
colon bacteria. The result: When patients take those antibiotics,
particularly clindamycin, competing bacteria die off and C-diff
explodes.


One of the 33 patients in the report died -- a 31-year-old Pennsylvania

woman who was 14 weeks pregnant with twins when she first went to the
emergency room with symptoms. Despite treatment with antibiotics
considered
effective against C-diff, she lost the fetuses and then died.


Ten of the 33 were otherwise healthy pregnant women or women who had
recently given birth who had had brief hospital stays. The rest were
people
in the Philadelphia area who had not been in a hospital in the three
months
before their illness.


The New England Journal of Medicine article looked at C-diff samples
taken
between 2000 and 2003 from eight hospitals in six states -- Georgia,
Illinois, Maine, New Jersey, Oregon and Pennsylvania.

.

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