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'Extraordinary resources' needed to tackle C. diff

2 February 10 12:33 GMT

Scotland must invest "extraordinary resources" to clear hospitals of the deadly clostridium difficile (C. diff) infection, a leading expert has warned.

Canadian Dr Mark Miller has told a conference in Edinburgh that ongoing vigilance was required.

His warning comes a day after the first public session of the inquiry into the C. diff deaths at the Vale of Leven Hospital in Dunbartonshire.

The health secretary said all possible lessons would be learnt from outbreaks.

In Scotland C. diff has overtaken MRSA as the leading cause of deaths from hospital-acquired infections, and it is rapidly becoming resistant to antibiotic treatment.

Resistant infections

Nicola Sturgeon, the minister responsible for health, called on doctors to be prudent in their prescribing of antibiotics as part of efforts to control the spread of infections which are resistant to the drugs.

Speaking at the event organised by the Royal College of Physicians of Edinburgh, Ms Sturgeon said: "Too many people believe antibiotics can cure all ills.

"And too many people expect to get one every time they visit their GP.

"We all must understand that only prudent prescribing can halt the rise in resistant infections and ensure that when we really need antibiotics that they remain effective."

C. diff rates and deaths are known to have risen, although it is hard to obtain an accurate picture of the trend.

In the period 2000-2008 the General Register Office for Scotland reported an increase in the number of C. diff deaths from 116 to 765.

Dr Mark Miller told Scottish doctors and microbiologists at the conference on Hospital Acquired Infection about the lessons learned from the Canadian experience.

When the infection took hold there it was contained following stringent infection control procedures.

Dr Miller, who is from the Jewish General Hospital and McGill University in Montreal, said: "Extraordinary resources were required in each instance to control the epidemics and it is likely that similar interventions will be required in Scotland."

He added that it was vital healthcare teams did not view C. diff epidemics as requiring a one-off control strategy at the time of the outbreak.

"Any lapses in the increased level of infection control are usually followed by an increase in C. diff rates and related deaths," he said.

The health secretary said an extensive range of new initiatives had been introduced.

Ms Sturgeon said: "Encouragingly, we are now seeing significant and sustained reductions in the number of cases and we would expect the annual death rates to mirror this trend.

"The Canadian cases date back to 2002/03 and we have already learned from these and other international cases in determining our Scottish strategy.

On Monday the first public session of an inquiry into the C. diff deaths at the Vale of Leven Hospital in Dunbartonshire was held.

The hearing will also look into the handling of an outbreak at Ninewells Hospital in Dundee last year, in which five people died.

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