16 deaths linked to C Diff outbreak at one hospital
A leading health expert last night warned that the virulent hospital bug C Diff could now be a bigger threat than MRSA after it emerged that 16 patients were found to have died in the country's biggest outbreak.
An investigation by the infection control team at Vale of Leven Hospital in West Dunbartonshire revealed 54 people had been treated for a particularly deadly strain of C Diff in the six months to June 1, Greater Glasgow and Clyde NHS said yesterday.
Eight people died as a direct result of the 027 strain and the bug was found to have contributed to the deaths of a further eight people, the health board said.
Another six patients with the infection died at the hospital, but the board said the C Diff played no role in these cases.
The outbreak is the clearest sign yet that C Diff has taken root in Scotland. It had previously been considered more of a problem south of the border. The first Scottish case of 027 was diagnosed in October 2006.
Hugh Pennington, emeritus professor of bacteriology at Aberdeen University, described the latest outbreak as a major threat to Scottish hospitals.
He said: "There's no absolute proof, but it does seem to be particularly good at spreading in hospitals and that may be one of the reasons it has become more common."
He added that there was reason to believe C Diff was more of a priority than MRSA, warning: "A lot more people die from C Diff and it kills people quite speedily compared with MRSA, which can take months to kill."
After an emergency outbreak control meeting on Tuesday to discuss the latest worrying developments, it was agreed to conduct an urgent review of the use of antibiotics, which can contribute to C Diff infections by destroying other bacteria in the gut that would normally fight against it.
The board's hand hygiene co-ordinator has also been sent to the hospital to investigate improvements to hand-washing facilities and compliance with hygiene protocols at the hospital.
Of the 54 infected patients, only 13 had contracted C Diff before entering the hospital.
The emergency measures follow the completion of an investigation of C Diff cases in the Clyde area ordered in March after a "cluster" of three people were found to have the bug - two at Vale of Leven and one at the Royal Alexandria Hospital in Paisley. One of those patients died.
A further meeting of the outbreak control team, which includes members of the health board's Public Health Protection Unit, Health Protection Scotland and infection control leaders, is scheduled for this afternoon.
Hygiene experts last night warned the growth of C Diff, particularly the 027 strain, raised questions about the suitability of hygiene procedures introduced in UK hospitals to tackle the spread of MRSA.
While alcohol wipes and gels common on Scottish wards are seen as effective
in combating MRSA, they do not kill C Diff spores and there is some evidence alcohol may even promote their growth.
Mr Pennington called for a Scottish-wide review to examine whether it was necessary to revert to "old-fashioned" hand-washing methods.
"One of the issues is that there is so much emphasis on alcohol gels and wipes. For MRSA, these are fine but they don't do much to combat
C Diff," he said.
"We may need to go back to the old-fashioned method of hand-washing in sinks using soap as it appears to be the only thing that keeps C Diff at bay."
A spokeswoman for Health Protection Scotland, the
NHS agency tasked with
preventing disease and infection outbreaks, said it supported measures taken by NHS Greater Glasgow and Clyde and was working
with infection control teams from other health boards
to contain the spread of
C Diff.
Dr Syed Ahmed, chair of the NHSGGC outbreak control team, said he was "particularly concerned" about the number of deaths at Vale of Leven between last December and June 1.
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Posted by: bob mckay, glasgow on 11:48pm Wed 11 Jun 08
Lets sue!! Lets sue the NHS! Bet they meant to kill those old people!
What do you mean when you sue the NHS you sue yourself, ourselves? What do you mean health professionals life work is saving lives!! We need to blame someone...and i cant sue a virus!!!
PS Washing hands......good idea that.
Lets sue!! Lets sue the NHS! Bet they meant to kill those old people!
What do you mean when you sue the NHS you sue yourself, ourselves? What do you mean health professionals life work is saving lives!! We need to blame someone...and i cant sue a virus!!!
PS Washing hands......good idea that.
Posted by: a voice of reason, Glasgow on 12:02am Thu 12 Jun 08
hmmm. whilst the 16 deaths are just horrific for the patients and their families left behind, the cynic in me wonders if this negative publicity is playing into NHS Greater Glasgow and Clyde's hands. So long the VOL has had the unforunate nickname "The Vale of Death" amongst medical students, nurses and doctors alike. NHS GG&C plan to close the VOL or at least remove all acute services turning it into an old folks home. Just like the negative publicity about the Victoria Infirmary suited NHS GG&C with the local populus not as distressed about its closure as it was beforehand, likewise the communities served by the VOL.
hmmm. whilst the 16 deaths are just horrific for the patients and their families left behind, the cynic in me wonders if this negative publicity is playing into NHS Greater Glasgow and Clyde's hands. So long the VOL has had the unforunate nickname "The Vale of Death" amongst medical students, nurses and doctors alike. NHS GG&C plan to close the VOL or at least remove all acute services turning it into an old folks home. Just like the negative publicity about the Victoria Infirmary suited NHS GG&C with the local populus not as distressed about its closure as it was beforehand, likewise the communities served by the VOL.
Posted by: Anne, Glasgow on 1:05am Thu 12 Jun 08
Part 3
C-diff is responsible for more deaths in the US than all other intestinal infections combined.
The recent global emergence of a hypervirulent strain containing binary toxin (Toxinotype III ribotype 027) with or without deletion in a regulatory gene (tcdCgene), together with high-level resistance to third generation fluoroquinolones, has been associated with increased morbidity and mortality.
Some recently described strains produce an additional toxin, an adenosine-diphosphat
e ribosyltransferase known as binary toxin, the role of which in pathogenicity is unknown.
The use of fluoroquinolone antiancrobials appears to be acting as a selective pressure in the emergence of the strain.
The current state of knowledge about C-diff is described as a cause of diarrhoeal illness.
Findings of CDAD - Clostridium difficile -associated diarrhoea by Elliott, Chang, Golledge and Riley.
Many patients with life threatening forms of C-diff colitis have a colectomy. The time period that C-diff became severe occurred between 1993 and 2003.
Part 3
C-diff is responsible for more deaths in the US than all other intestinal infections combined.
The recent global emergence of a hypervirulent strain containing binary toxin (Toxinotype III ribotype 027) with or without deletion in a regulatory gene (tcdCgene), together with high-level resistance to third generation fluoroquinolones, has been associated with increased morbidity and mortality.
Some recently described strains produce an additional toxin, an adenosine-diphosphat
e ribosyltransferase known as binary toxin, the role of which in pathogenicity is unknown.
The use of fluoroquinolone antiancrobials appears to be acting as a selective pressure in the emergence of the strain.
The current state of knowledge about C-diff is described as a cause of diarrhoeal illness.
Findings of CDAD - Clostridium difficile -associated diarrhoea by Elliott, Chang, Golledge and Riley.
Many patients with life threatening forms of C-diff colitis have a colectomy. The time period that C-diff became severe occurred between 1993 and 2003.
Posted by: subrosa on 4:27am Thu 12 Jun 08
[italic]posted by: Anne, Glasgow on 1:05am today[/italic]
Interesting post Anne. I'm a survivor of this bug but am left with long term health problems partly due to a doctor who left me for over 2 weeks saying it was just bad food poisoning. Terrible illness to have and hospitals need to rethink their methods of distributing metrodiazole after any operation (that happened to me) and also hygiene methods.
I could rant on and on but your post puts it far more succinctly.
posted by: Anne, Glasgow on 1:05am today
Interesting post Anne. I'm a survivor of this bug but am left with long term health problems partly due to a doctor who left me for over 2 weeks saying it was just bad food poisoning. Terrible illness to have and hospitals need to rethink their methods of distributing metrodiazole after any operation (that happened to me) and also hygiene methods.
I could rant on and on but your post puts it far more succinctly.
Posted by: Bill Irvine, West Lothian on 9:19am Thu 12 Jun 08
Meanwhile the Government gets het up about a War on Terrorism.
Mind you, you could be safer spending 42 days in prison than a week in hospital. And do not dare carry a bottle of water into an airport, but carry as many germs into hospital as you like.
Meanwhile the Government gets het up about a War on Terrorism.
Mind you, you could be safer spending 42 days in prison than a week in hospital. And do not dare carry a bottle of water into an airport, but carry as many germs into hospital as you like.
Posted by: Katharine Morrison, Mauchline on 9:23am Thu 12 Jun 08
"We may need to go back to the old-fashioned method of hand-washing in sinks using soap as it appears to be the only thing that keeps C Diff at bay."
This is correct. Unfortunately many hospital wards were not designed with C.diff limitation tactics in mind. An increase in handwashing sinks with foot pedals or other no touch system to operate the taps will be needed and needed urgently.
There are other possible products that can be used to kill off C.diff in the absence of adequate handwashing facilities notably AQ+ .
The extent to which action will be taken and the speed of change depends on us all refusing to sweep this health menace under the carpet. Unfortunately the "it won't happen to me" idea is very widespread.
Patients, visitors, health care staff, cleaners and administrators all have important parts to play.
Firstly, please ask the doctor if there is any other approach instead of using an antibiotic that would be helpful in dealing with an illness.
I am a doctor myself and I admit that I do prescribe antibiotics due to patient pressure or nurse pressure to do something rather than await spontaneous resolution of certain illnesses.
Secondly, doctors need to know what antibiotics are best to be prescibed and which should be avoided for specific conditions.
Thirdly, wash your hands before and after patient contact and before and after food preparation and eating and of course after using the toilet.
Ask for adequate handwashing and drying facilities to be provided at your place of work and in health care facilities.
"We may need to go back to the old-fashioned method of hand-washing in sinks using soap as it appears to be the only thing that keeps C Diff at bay."
This is correct. Unfortunately many hospital wards were not designed with C.diff limitation tactics in mind. An increase in handwashing sinks with foot pedals or other no touch system to operate the taps will be needed and needed urgently.
There are other possible products that can be used to kill off C.diff in the absence of adequate handwashing facilities notably AQ+ .
The extent to which action will be taken and the speed of change depends on us all refusing to sweep this health menace under the carpet. Unfortunately the "it won't happen to me" idea is very widespread.
Patients, visitors, health care staff, cleaners and administrators all have important parts to play.
Firstly, please ask the doctor if there is any other approach instead of using an antibiotic that would be helpful in dealing with an illness.
I am a doctor myself and I admit that I do prescribe antibiotics due to patient pressure or nurse pressure to do something rather than await spontaneous resolution of certain illnesses.
Secondly, doctors need to know what antibiotics are best to be prescibed and which should be avoided for specific conditions.
Thirdly, wash your hands before and after patient contact and before and after food preparation and eating and of course after using the toilet.
Ask for adequate handwashing and drying facilities to be provided at your place of work and in health care facilities.
Posted by: Rab Jones, Glasgow on 9:57am Thu 12 Jun 08
[quote][bold]Bill Irvine[/bold] wrote:
Meanwhile the Government gets het up about a War on Terrorism. Mind you, you could be safer spending 42 days in prison than a week in hospital. And do not dare carry a bottle of water into an airport, but carry as many germs into hospital as you like.[/quote] Great point.
I believe more people have died in the last 5 years in hospital than being attacked by terrorism.
What a great world we live in.
My brother in law is 41 and is to go in to get his appendix out. This used to be a straightforward routine operation, now he's worried in case he dies there because of all the germs.
Bill Irvine wrote:
Meanwhile the Government gets het up about a War on Terrorism. Mind you, you could be safer spending 42 days in prison than a week in hospital. And do not dare carry a bottle of water into an airport, but carry as many germs into hospital as you like.
Great point.
I believe more people have died in the last 5 years in hospital than being attacked by terrorism.
What a great world we live in.
My brother in law is 41 and is to go in to get his appendix out. This used to be a straightforward routine operation, now he's worried in case he dies there because of all the germs.
Posted by: Anne, carpe diem on 10:43am Thu 12 Jun 08
Research at the Uni of Southampton showed that copper surfaces can virtually eradicate the influenza A virus. The news was issued two years ago.
Microbiology researcher Prof Bill Keevil (working together with Dr Jonathan Noyce) explained that the findings were so pertinent to current concerns about containing a potential outbreak of the avian flu strain that they felt it important to provide some of the preliminary results at that time.
He also explained that copper's antimicrobial action probably attacks the overall structure of the virus and therefore has [bold]a broad spectrum[/bold] effect.
The results were "consistent with the demonstrated antimicrobial effects of copper cited in published studies on E. coli 0157: H7, MRSA, and Listeria"said Prof Keevil, adding that similar antimicrobial efficacy may be achieved by the infusion of copper ions into fabrics, filters or other materials".
Door knobs and handles , push plates, countertops, sinks and other public facilities are prime candidates for use of copper alloys to help control the spread of infection.
Some institutions have already installed the copper in their buildings.
Research at the Uni of Southampton showed that copper surfaces can virtually eradicate the influenza A virus. The news was issued two years ago.
Microbiology researcher Prof Bill Keevil (working together with Dr Jonathan Noyce) explained that the findings were so pertinent to current concerns about containing a potential outbreak of the avian flu strain that they felt it important to provide some of the preliminary results at that time.
He also explained that copper's antimicrobial action probably attacks the overall structure of the virus and therefore has
a broad spectrum effect.
The results were "consistent with the demonstrated antimicrobial effects of copper cited in published studies on E. coli 0157: H7, MRSA, and Listeria"said Prof Keevil, adding that similar antimicrobial efficacy may be achieved by the infusion of copper ions into fabrics, filters or other materials".
Door knobs and handles , push plates, countertops, sinks and other public facilities are prime candidates for use of copper alloys to help control the spread of infection.
Some institutions have already installed the copper in their buildings.
Posted by: Anne on 10:53am Thu 12 Jun 08
~The test
The Southampton researchers placed 2m plaque forming units of Influenza (H1N1) on coupons of C11000 copper (common, pure copper sheet metal) and on S 30400 (common stainless steel) at roomtemperature.
On stainless steel surface, the pathogen declined to 1m after six hours and to 500,000 after 24 hours, while the copper surface reached a reduction to 500,000 just after one hour and inactivated all but 500 - a 99,99% reduction - after just six hours.
Azon. com
~The test
The Southampton researchers placed 2m plaque forming units of Influenza (H1N1) on coupons of C11000 copper (common, pure copper sheet metal) and on S 30400 (common stainless steel) at roomtemperature.
On stainless steel surface, the pathogen declined to 1m after six hours and to 500,000 after 24 hours, while the copper surface reached a reduction to 500,000 just after one hour and inactivated all but 500 - a 99,99% reduction - after just six hours.
Azon. com
Posted by: Anne on 11:40am Thu 12 Jun 08
Posted March 26, 2008
EPA, the US environmental Protection Agency has approved the registration of antimicrobial copper alloys with public health claims.
Copper is the first solid surface material to receive this type of EPA registration, which is supported by extensive antimicrobial efficacy testing.
The registration include the following statement, that the use of a copper alloy surface is a supplemnet to and not a substitute for standard infection control practices.
The coppper alloy surface material has been shown to reduce microbial contamination, but is does [bold]not necessarily prevent cross contamination[/bold].
Unlike coatings or other materials treatments, the antibacterial efficacy of copper metal won't wear away; they can offer solid, longterm protection.
Discussions are ongoing with major hospital equipment manufacturers about the development of appropriate copper-based products.
Posted March 26, 2008
EPA, the US environmental Protection Agency has approved the registration of antimicrobial copper alloys with public health claims.
Copper is the first solid surface material to receive this type of EPA registration, which is supported by extensive antimicrobial efficacy testing.
The registration include the following statement, that the use of a copper alloy surface is a supplemnet to and not a substitute for standard infection control practices.
The coppper alloy surface material has been shown to reduce microbial contamination, but is does
not necessarily prevent cross contamination.
Unlike coatings or other materials treatments, the antibacterial efficacy of copper metal won't wear away; they can offer solid, longterm protection.
Discussions are ongoing with major hospital equipment manufacturers about the development of appropriate copper-based products.
Posted by: Corrupt EU, Fife on 12:51pm Thu 12 Jun 08
Contamination is gruesome.
http://www.youtube.c
om/watch?v=6PqXw6mS2
KA
Contamination is gruesome.
http://www.youtube.c
om/watch?v=6PqXw6mS2
KA
Posted by: Anne on 2:43pm Thu 12 Jun 08
[quote]http://www.youtube.c
om/watch?v=6PqXw6mS2
KA[/quote] What a silly referral!
The Beegees?
http://www.youtube.c
om/watch?v=6PqXw6mS2
KA
What a silly referral!
The Beegees?
Posted by: Jim Dwyer, Nokomis, FL, USA on 4:19pm Mon 21 Jul 08
What a shame that 16 families lost loved ones due to the spread of c-diff! I've been deeply involved with preventing the spread this potentially deadly bacteria, and have come to the conclusion that containment is the only sure way to go.
A regime of hand-washing and consciously keeping one's fingers out of the mouth, nose and eyes should be general practice for everyone at all times: a given.
All chemical companies will be the first to state that they will be able to kill c-diff in the vegetative form, but not when c-diff is in the spore form, which can survive for up to 5-months before developing back into the reproductive, vegetative form!
Containment methods are universal (diapers, chucks, gloves, etc) EXCEPT while bathing or showering. The UK has smartly banned jetted tubs (whirlpools) in long-term care facilities, but spatter on the shower is the biggest breach in the protective wall against the spread of c-diff! From the shower floor, onto shoes and chair wheels, it is efficiently spread through out the facility.
We have developed the Melanie Spa to fill the gap in that wall of protection. Visit www.davidstorm.com to see how it works. Sorry, the web site is primitive and in the midst of upgrade, but the demo video will tell the story.
The Melanie is not the whole answer to the problem, but a good portion of it! Melanie is a great tool for the prevention of infection, patient dignity, the efficiency of staff and the management of water use.
We're actively looking for UK distributors to help us wage this war!
Jim Dwyer
What a shame that 16 families lost loved ones due to the spread of c-diff! I've been deeply involved with preventing the spread this potentially deadly bacteria, and have come to the conclusion that containment is the only sure way to go.
A regime of hand-washing and consciously keeping one's fingers out of the mouth, nose and eyes should be general practice for everyone at all times: a given.
All chemical companies will be the first to state that they will be able to kill c-diff in the vegetative form, but not when c-diff is in the spore form, which can survive for up to 5-months before developing back into the reproductive, vegetative form!
Containment methods are universal (diapers, chucks, gloves, etc) EXCEPT while bathing or showering. The UK has smartly banned jetted tubs (whirlpools) in long-term care facilities, but spatter on the shower is the biggest breach in the protective wall against the spread of c-diff! From the shower floor, onto shoes and chair wheels, it is efficiently spread through out the facility.
We have developed the Melanie Spa to fill the gap in that wall of protection. Visit www.davidstorm.com to see how it works. Sorry, the web site is primitive and in the midst of upgrade, but the demo video will tell the story.
The Melanie is not the whole answer to the problem, but a good portion of it! Melanie is a great tool for the prevention of infection, patient dignity, the efficiency of staff and the management of water use.
We're actively looking for UK distributors to help us wage this war!
Jim Dwyer
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