Current Threats to Public Health Clostridium difficile and other Superbugs

What is it? Clostridium difficile are rod shaped, anaerobic, gram positive bacteria that naturally grow in our intestines. They become a problem when they overpopulate our intestines and drive other helpful bacteria out.

What is it? The overpopulation is harmful because these bacteria can release toxins that can cause bloating, constipation and diarrhea. They are the number one cause of antibiotic associative diarrhea in hospitals and long-term care facilities.

What are the symptoms? The major sign of a C. difficile infection is major diarrhea. It is usually accompanied by abdominal pain. Each patient has had exposure to antibiotics previous to the onset of symptoms.

How does one develop a C. difficile infection? Use of broad spectrum antibiotics to fight off another bacterial disease or to prevent infection after surgery kill off normal bacteria that grow in your gut and C. difficile takes over.

How is it transmitted? C. difficile bacteria are found in feces. People can get infected if they use their hands to touch surfaces contaminated with feces, and then touch their mouths or eyes. Healthcare workers can spread the bacteria to their patients if their hands are contaminated.

Who is at risk? Healthy people don’t usually get C. difficile. People who have other illnesses or conditions requiring the use of antibiotics and the elderly are at greater risk of infection.

Why should we be concerned? C. difficile is resistant to most antibiotics. It is the start of what many scientists believe will be a string of antibiotic resistant bacteria. In some cases the dehydration caused by C. difficile can be fatal.

When did it become a problem? In June of 2003, it was diagnosed in hospitals in Calgary and Montreal. By the end of 2004, 1400 cases were documented (mainly in Quebec) and 89 people died. In 2005 it showed up in the Toronto area and outbreaks have been recorded every year since at hospitals or long-term care facilities.

What was PHAC’s response? PHAC has been surveying hospitals and long-term care facilities since 2003. It has put out a guideline for C. difficile. It has put into place, guidelines for healthcare workers and laboratory workers for dealing with infectious patients and biohazardous materials (i.e. feces).

How do we protect ourselves from getting C. difficile? As with any infectious disease, frequent hand-washing is one of the best defenses against the spread of C. difficile. If you work or visit a hospital or long-term healthcare facility, wash your hands often, especially after using the toilet. Most healthcare facilities provide an alcohol-based hand sanitizer at the entrance. Be sure to use it. If your hands are visibly soiled, use soap and water to wash them instead of an alcohol-based hand sanitizer. Saccharomyces boulardii (a yeast found in lychee fruit) is the only probiotic worldwide known to diminish levels of C. difficile in the body (OptiBac Probiotics).

What happens if I already have a C. difficile infection? If the symptoms are mild, you may need no treatment, just wait out the return of the healthy bacteria back to your gut. If it is more severe, treatment with antibiotics is needed (i.e. Metronidazole) If left untreated, perforated bowels may require surgery!

VRE destroying lung tissue Other “Super Bugs” VRE: Vancomycin Resistant Enterococcus Can cause urinary tract infections and various nasty things including meningitis. MRSA: Methicillin Resistant Staphylococcus aureus. Skin and soft tissue can become infected and pus filled boils and holes can occur Can lead to “flesh-eating” disease and toxic shock. VRE destroying lung tissue

Other “Superbugs” More and more “superbugs” are appearing due to the overuse and misuse of antibiotics. Strains of bacteria that cause gonorrhea and tuberculosis are showing multi-drug resistance. Many opportunistic bacteria such as Pseudomonas aeruginosa are becoming more and more difficult to treat! Now we are turning to other types of treatment and therapy rather than antibiotics in the hopes of reducing the appearance of “superbugs”.