C.diff infections likely to rise this year with antibiotics to blame

The inappropriate prescription of antibiotics by GP practices is partly to blame for the periodic occurrence of the Clostridium difficile bug in Altnagelvin and other hospitals, according to Dr. Dermot Hughes, the Western Trust's Medical Director.

Tuesday, 16th January 2018, 8:30 pm

Dr. Hughes said the over-use of antibiotics was a major cause of the unpleasant C. diff. infection, which attacks the bowels, causing diarrhoea and stomach cramps.

Dr. Dermot Hughes, Medical Director at the Trust, told the monthly meeting of the Western Trust Board that while there has not been a single case of meticillin-resistant Staphylococcus aureus (MRSA) at Altnagelvin in two-and-a-half years, the elimination of C. diff. is proving a much greater challenge.

While there were 56 cases in Western Trust hospitals in 2016/17, there have already been 53 reported cases in 2017/18 to date. It’s thus expected that a year-on-year increase will eventually be reported in April.

Dr. Hughes said that of the 53 cases, 29 were acquired in hospitals and 24 in the community.

The Trust medical chief said that the over-prescription of antibiotics was to blame.

“In hospitals most of the antibiotic prescriptions were appropriate, it’s not the same in the community, the threshold is lower,” he explained.

Dr. Hughes said the presence of embedded pharmacists with greater expertise and knowledge of antimicrobials than GPs in practices and health centres throughout the Western Trust could help address the issue.

He also said there was now an ingrained culture of vigilance against MRSA across the Trust and that the challenge was to replicate this for C. diff.

Dr. George Mcilroy suggested that in light of a projected 20 per cent increase in C. diff. infections by the end of 2017/18, rather than the 20 per cent reduction aimed for, the Trust’s targets may have been overly ambitious.

Medical experts point out that the development and spread of the contagious C. diff. infection is encouraged when people undertake courses of antibiotics, often uselessly, to treat the symptoms of viral infections like the cold and the flu.

“Many C. diff. infections used to occur in places where many people take antibiotics and are in close contact with each other, such as hospitals and care homes.

“However, strict infection control measures have helped to reduce this risk, and an increasing number of C. diff. infections now occur outside these settings,” explains the NHS literature.