By Thomas A. Cumbo
Niagara Gazette — In recent weeks, various media outlets have discussed the challenges being faced by hospitals trying to control outbreaks of a disease called Clostridum difficile.
We would like our community to understand some basics about this and other infections seen in the nosocomial (hospital) setting. We would also like to explain our approach to preventing the same at Mount St. Mary’s Hospital.
C. difficile, a common nosocomial infection, can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon. It spreads as a spore which allows it to live in the environment for a long time and makes it difficult to disinfect. Illness from C. difficile frequently affects older adults in hospitals or in long term care facilities and typically occurs after use of antibiotic medications. In recent years many C. difficile infections have become severe and difficult to treat. Some resistant strains of the bacterium produce significant amounts of toxin and can cause critical illness.
Doctors have long been concerned that the overuse of antibiotics is making the treatment of bacterial infections more difficult. When bacteria are exposed to antibiotics, a few resistant strains may survive, reproduce and spread. In hospitals worldwide, including the US and Canada, there are infections that can only be treated with old and dangerous antibiotics or are completely resistant to antibiotic therapy altogether. In such a scenario, what is today a relatively mild illness such as appendicitis or a middle ear infection would carry a mortality risk similar to that seen before the discovery of penicillin. Alarmingly, a resistant bacterium can travel halfway around the world in less than a day with modern travel modalities.
What can we do? First, understand that viral infections will not respond to antibiotic therapy. Many flu-like illnesses that commonly occur are viral in nature. All that antibiotics will do in such a case is kill off many of the “good” bacteria that we all need in our digestive tract and will allow resistant bacteria (such as C. difficile) to spread. There is a resurgence of interest in the medical community regarding the protective role that these bacterial strains may play in our overall health.
Second, wash hands regularly with soap and warm water especially when ill or in contact with ill persons. Bacteria die in the presence of soap.
Third, if you or a loved one happens to be in the hospital, please follow all infection control mandates including gowns and gloves if directed to do so. This will help keep the spread of bacteria down throughout the campus.
Over the past three years, we have invested significant resources into our successful infection control and antibiotic stewardship programs. We emphasize antimicrobial streamlining and reduction in a clinically responsible manner. The recent recognition we received from Consumer Reports as the top hospital in Western New York for safety spotlights our achievements.
All hospitals are concerned about infection control and are aware that it takes a team effort involving staff, physicians, patients and visitors to be successful. We’re all in this together, so please take the time to learn and digest the above information to help make our community safer from drug-resistant and difficult to treat infections.Thomas A. Cumbo, MD, is the head of Infectious Diseases Division at Mount St. Mary's Hospital, Lewiston