March 14, 2019
草莓污视频导航 researchers partner with AHS to tackle dangerous bug in hospitals
Cases of Clostridium difficile infection, often called C. diff, the most common cause of hospital-associated diarrhea, appear to be down about 30 per cent as part of a new strategy at Calgary adult acute care hospitals.
草莓污视频导航 researchers and Alberta Health Services (AHS) are providing patients with probiotics in an effort to prevent the sometimes-deadly but often serious infection. C. diff bacteria are abundant in nature and may be resistant to antibiotics and certain disinfectants. Spores can survive for months on hospital surfaces, despite exhaustive measures to keep them in check.
As part of a three-year initiative being conducted through the W21C (Ward of the 21st Century) and co-led by Dr. John Conly, MD, an infectious disease specialist and member of both the and the at the and pictured above, it is expected tens of thousands of Calgary hospital patients will participate in the program. Candidates are men and women aged 55 and older who have received a prescription for antibiotics. Patients must have a functioning bowel, are not receiving cancer chemotherapy and do not have compromised immune systems. Those who qualify receive Bio K+, a Canadian-made probiotic recognized by Health Canada for prevention of diarrhea from antibiotics. The initiative is now underway at South Health Campus, Rockyview General Hospital, Peter Lougheed Centre and Foothills Medical Centre.
鈥淭he early results are promising and indicate probiotics may be effective in preventing C. diff,鈥 says Conly, who is a professor in the departments of , pathology and laboratory medicine, and microbiology, immunology and infectious diseases at the CSM. 鈥淭he theory is, by improving overall gut health the body can ward off the onset of C. diff, which is a spore-forming bug that causes severe diarrhea and inflammation of the colon.鈥
How a diagnosis of C. diff affects your life
Bruce Dalton, an infectious diseases pharmacist with AHS and member of the O鈥橞rien Institute, says many people suffer for years with C. diff. 鈥淚t鈥檚 more than just uncomfortable, it can inflame the colon to the point where the colon can leak, which leads to sepsis and even death.鈥
Since 2011, Alberta Health Services Infection Prevention and Control has attributed over 500 deaths to C. diff.
Michelle Myers, 61, underwent a fecal transplant last July to try to end the suffering she was experiencing. Fecal transplants restore compromised colonic microflora by introducing fecal bacteria from a healthy individual. The transplants are considered to be a last resort to treating this disease.
鈥淚 had never heard of C. diff until I acquired it in 2014 after a bone marrow transplant to treat lymphoma,鈥 she says. 鈥淭he infection disappeared after treatment but returned in 2017 when I was admitted to hospital for another bone marrow transplant."
Myers experienced numerous treatments and hospital visits to replenish the fluids robbed by infection. 鈥淚t made my life really, really difficult. I was unable to do the things I enjoy 鈥 I was basically tied to a bathroom,鈥 Myers says. 鈥淢y life has returned to normal after the fecal transplant. I can be active again and enjoy dinner out with friends. Prior to the transplant, I didn鈥檛 go anywhere because I was afraid I might have an accident and make a spectacle.鈥
Dalton adds some people will have 12, 18 or even 20 reoccurrences. 鈥淚t comes to the point where the most effective therapy, as Michelle discovered, is a fecal transplant,鈥 he says.
The financial impact of C. diff is enormous
Along with being devastating for the people who have it, C. diff infections are an enormous burden on health systems. Patients require isolation, consultations by gastroenterologists and infectious disease specialists, and longer hospital stays.
Canada saw almost 38,000 cases of C. diff infection in 2012, the majority of which were hospital-acquired, according to that pegged the nationwide cost in care and lost productivity at $281 million.
Alberta sees over of hospital-acquired C. diff every year, a number this team hopes to lower. 鈥淓ven if we don鈥檛 eliminate all cases of C. diff, by reducing the numbers we can reduce the chance of another patient contracting it,鈥 says Conly, who is also the medical director of in the O鈥橞rien Institute.
The initial phase of the initiative ends this fall. Conly says if the preliminary results hold up, the use of probiotics in all AHS acute care facilities may be considered as a strategy to reduce C. diff.
The initiative is funded by , in partnership with AHS. Conly鈥檚 co-leads on this project are Drs. Thomas Louie and Jayna Holroyd-Leduc.
Dr. Holroyd-Leduc, MD, is professor in the departments of medicine and and a member of the and O鈥橞rien Institute for Public Health.
Dr. Louie, MD, is a clinical professor in the departments of and at the Cumming School of Medicine. He is also professor emeritus and member of the .