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C. difficile colitis becoming more common and severe in hospitalized patients
C. difficile colitis becoming more common and severe in hospitalized patients

July 17, 2007 (Insidermedicine) The rate of colitis caused by the bacteria Clostridium difficile has more than doubled among patients hospitalized in the US over an 11-year span, according to a report published in the Archives of Surgery.

Approximately 1 to 2% of healthy adults and about 20% of patients receiving antibiotics have C. difficile bacteria in their intestines. When the balance of bacteria in the colon is altered C. difficile can cause a variety of symptoms, including severe diarrhea that may be fatal. Treatment of life-threatening forms of the disease usually involves removal of all or part of the colon, which is associated with high rate of complications and death. It is estimated that about three million new cases of C. difficile colitis occur in the US each year, and as many as 10% of patients hospitalized for at least two days are affected. There is some evidence to show that the disease has become more common and potentially more severe.

To determine the prevalence and severity of C. difficile colitis, researchers analyzed data from approximately 20% of community hospitals in the US between 1993 and 2003. 

Over the 11-year study period, the rate of C. difficile increased by 109%, colon surgery rates nearly tripled, and death rates increased by 147%. The rate of C. difficile diagnosis increased each year, and the likelihood of colon surgery and death also increased significantly over time.

While the analysis reveals increased prevalence and severity of disease, it does not offer explanations for the change. New strains of bacteria and its increasing resistance to antibiotics may be responsible for the shift, and perhaps the increasing severity of underlying illness, and therefore susceptibility to infection among hospitalized patients in the US.

Based on the alarming trend, heightened awareness about the increasing burden of the disease is an important first step in controlling the spread of C. difficile in US hospitals. 

Reporting for Insidermedicine, I’m Dr. Susan Sharma.