Undiscovered Clostridium difficile infections

Hospital germs: More than 39,000 undetected Clostridium difficile infections annually

05/12/2014

Across Europe, more than 39,000 cases of Clostridium difficile infection (CDI) go undetected each year. This mainly because of lack of clinical suspicion or inadequate laboratory tests. The risk of contracting such a diarrheal hospital infection is high, especially for older patients.

Over 39,000 undetected cases a year
The 24th European Congress on Clinical Microbiology and Infectious Diseases (ECCMID), to be held in Barcelona from May 10 to 13, has been the largest ever study of Clostridium difficile infection (CDI) in Europe, the so-called EUCLID study , presents. As the data from 482 hospitals in 20 European countries shows, an average of 109 cases of CDI remain undetected in one day due to lack of clinical suspicion or inadequate laboratory tests. As a result, there are potentially more than 39,000 undetected cases a year in Europe.

Infection can become life threatening
The disease arises as a result of an infection of the intestinal inner wall with the bacterium C. difficile. Typical signs include diarrhea, abdominal pain, intestinal inflammation and fever. In the worst case, the toxins of the pathogens lead to a life-threatening dissolution of the intestinal walls, after which the bacteria spread throughout the organism and can cause blood poisoning (sepsis). In this case, there is an acute danger to life for the patients. Typically, patients develop CDI after treatment with broad-spectrum antibiotics. In industrialized countries, CDI is the leading cause of hospital-acquired diarrhea, especially for older patients over the age of 65, the risk is high. In 25 percent of CDI patients, current therapies relapse within 30 days of treatment.

Increase in CDI disorders
As the study results show, there is an increase in CDI disorders. In addition, data show that the countries with the highest rates of CDI testing had the lowest rates of this C. difficile epidemic. „Countries with a greater awareness of CDI were more likely to reduce outbreaks associated with the most virulent C. difficile strains through improved early detection of this infection“, explained Professor Mark Wilcox, professor of medical microbiology at teaching hospitals and at the University of Leeds. His research group coordinates the EUCLID study.

Its a lot to do
In addition, the evaluation showed that the current guidelines and methods of CDI diagnostics have shifted noticeably towards improved test procedures and a more targeted selection of laboratory methods. „Guidelines recommend that hospitals test all unformed stool samples for CDI if the cause of the diarrhea is unknown“, so Professor Wilcox. „CDI is a disease that not only causes significant patient suffering, but also represents a huge economic burden for hospitals across Europe. These results show that much remains to be done to optimize the management and prevention of CDI.“ (Sb)

Image: Cornelia Menichelli