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'C.diff now a regular occurrence'

19 June 08 17:20 GMT

By Eleanor Bradford
BBC Scotland's health correspondent

All hospitals in Scotland have been told to review their death rates from Clostridium difficile following the outbreak at the Vale of Leven hospital.

An independent review is to be carried out into why it took so long for the outbreak to be identified, and whether standards at the hospital in Dunbartonshire were up to scratch.

The outbreak first came to light on 22 May when Greater Glasgow and Clyde Health Board revealed there were three cases of the virulent "027" strain at the Vale of Leven.

But it was only in June when the public learned the true scale of the outbreak. On 11 June the health board announced it had looked back over the previous six months and found 54 cases of C.diff.

Eight elderly people had died from the infection and it was a contributory factor in the deaths of a further eight people.

So how could this have gone unreported for so long?

That is now the subject of an independent review, to be carried out by an Aberdeen expert, Professor Cairns Smith. But in the meantime clues may lie in the national statistics already collected.

Alarm bells

According to the Information and Statistics Division of the NHS, in the last three months of 2007 alone there were 1,608 cases of C.diff in Scotland, all of them among over-65's.

Figures collected by the General Register Office for Scotland suggest it was a factor in the deaths of 417 people in 2006, the most recent year for which figures are available.

Clostridium difficile is not uncommon. Its rise has been brought about by the over-prescription of antibiotics, which knock out the body's natural ability to deal with bacteria living in the gut.

The deaths at the Vale of Leven may not have rung alarm bells because Clostridium difficile has now become a regular occurrence in wards caring for the elderly.

Professor Smith's review will establish what lessons can be learned, but will probably echo the conclusions of similar inquiries into other outbreaks.

In particular, an inquiry into an outbreak in Kent which killed 90 people between 2004-2006 concluded that nurses were too busy to wash their hands.

The Vale of Leven is not the only hospital dealing with regular outbreaks of C.diff.

It may have dealt with those outbreaks poorly, but only dramatic changes across the whole of the NHS in Scotland will really have an impact on what is clearly a national problem.

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