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Last Updated: Thursday, 5 April 2007, 23:46 GMT 00:46 UK
Call for hospital bug screening
C difficile
C difficile is more common than MRSA
Hospital patients should be screened for the Clostridium difficile bug, an expert says.

Figures have shown that seven times as many hospital patients in England have C. difficile as have MRSA.

Edinburgh University expert John Starr said rates were being driven by high numbers carrying it in the community, the British Medical Journal reported.

He said early diagnosis could help control the problem. But the government said targeted testing was better.

Only patients over the age of 65 with diarrhoea are currently routinely tested for C. difficile.

Screening is done in by testing faeces for certain toxins produced by the bacterium.

Recent data published by the Health Protection Agency showed that each year in England about 7,000 inpatients had MRSA infections, whereas more than 50,000 inpatients aged 65 years and over had C. difficile infections.

Early accurate diagnosis is fundamental to any infection control programme
John Starr,
Edinburgh University

Cases of C. difficile rose by 5.5% in 2006, whereas MRSA cases fell by 4.3% over a similar period.

C. difficile symptoms are usually mild, involving diarrhoea and stomach pains. But in severe cases it can cause inflammation of the bowel which can be life-threatening.

Dr Starr, an expert in geriatric medicine, said the numbers were likely to continue rising because the population was ageing and the elderly were most at risk.

After analysing date for England, he said one factor which might be driving infection rates was the number of people in the community carrying it - about 5% of the population.

He suggested one way to control C. difficile would be to screen people before they were admitted to hospital for planned operations to see if they carried the bacterium.

The latest figures raised the question of whether C. difficile could still be thought of as a purely "hospital-acquired infection", he added, and if that was the case screening could be the best weapon.

'Not practical'

"Control of C. difficile is difficult because, unlike MRSA, alcohol hand scrubs are ineffective and its spores are resistant to routine hospital cleaning," Dr Starr said.

"Early accurate diagnosis is fundamental to any infection control programme."

But the Department of Health said that one million patients were seen by the NHS every 36 hours, and it would not be practical to screen everyone.

A spokesman added: "We have no plans to introduce compulsory C. difficile testing for every patient admitted to hospital.

"Every trust should have a comprehensive plan to be used to proactively reduce the risk of all healthcare associated infections to patients."




SEE ALSO
Bug linked to 17 hospital deaths
30 Mar 07 |  England
Hospital bug deaths on the rise
22 Feb 07 |  Health
Q&A: Clostridium difficile
11 Jan 07 |  Health

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