Why you should be serious about C diff in nursing homes

[cs_content][cs_section parallax=”false” separator_top_type=”none” separator_top_height=”50px” separator_top_angle_point=”50″ separator_bottom_type=”none” separator_bottom_height=”50px” separator_bottom_angle_point=”50″ style=”margin: 0px;padding: 45px 0px;”][cs_row inner_container=”true” marginless_columns=”false” style=”margin: 0px auto;padding: 0px;”][cs_column fade=”false” fade_animation=”in” fade_animation_offset=”45px” fade_duration=”750″ type=”1/1″ style=”padding: 0px;”][cs_text]If you think that C diff in nursing homes is nothing to worry about, then think again. Not only can C diff result in severe diarrhoea for your residents and staff, it can also prove deadly.[/cs_text][/cs_column][/cs_row][cs_row inner_container=”false” marginless_columns=”false” style=”margin: 0px auto;padding: 0px;”][cs_column fade=”false” fade_animation=”in” fade_animation_offset=”45px” fade_duration=”750″ type=”1/1″ style=”padding: 0px;”][cs_text]Take for example the outbreak that happened at Maidstone and Tunbridge Wells hospitals when C diff was named as contributing to the deaths of 90 patients between 2004 and 2006.

Whilst 90 deaths from C diff may seem far too many already, this is only a small part of the picture. In fact, according to the Office for National Statistics, in 2012 there were 1,646 deaths involving Clostridium difficile (C. difficile) infection in England and Wales.

What is more, the ONS found that most of the deaths involving C diff occur among older people and that the number of deaths increases with age. For example, during 2010–12 the mortality rate for people with C diff aged 85 years and over was 812 deaths per million in England and Wales. In comparison, the mortality rate for people with C diff aged between 75 and 84 years was much lower at 235 deaths per million.

So why are the elderly more likely to die from C diff than younger people? According to research carried out into this very issue, it seems that having a weaker immune response is one of the key factors. Other reasons for a higher prevalence of C diff include antimicrobial use, increased frequencies of hospitalization and exposure to long-term care facilities.

Why is C diff in nursing homes such a concern?

The reason that care facilities are a factor is that, in places such as care homes and hospitals, C diff infection is more likely to take hold and spread.

That is partly because of the increased prevalence of antibiotic use in these environments, as some antibiotics can interfere with the balance of bacteria in the bowel, causing typically harmless levels of naturally occurring C diff bacteria to multiply and produce toxins that make the person ill.

When that person then has diarrhoea, the C diff bacteria turn into resistant cells called spores. These can survive for long periods on hands, surfaces (such as toilets), objects and clothing and can infect someone else if they get into their mouth.

Obviously, due to the fact that there are typically higher concentrations of people in places such as hospitals and care homes there is huge potential for the C diff bug to spread if not contained properly.

So how do you tell if one of your residents has C diff as opposed to another type of sickness bug?

As we have seen, it is antibiotics that cause the problem in the first place, so one of the most obvious signs of C diff infection is where a resident has persistent diarrhoea after finishing a course of antibiotics.

C diff symptoms can also include:

• blood in the diarrhoea
• severe tummy pain with a high fever, rapid heart rate or fainting
• signs of severe dehydration, such as being muddled and drowsy and passing little or no urine

Whilst you won’t be able to tell for sure whether the diarrhoea is the result of C diff until you have the resident’s stools tested, you should follow the Department of Health’s ‘SIGHT’ advice for managing suspected potentially infected diarrhoea:

• Suspect that a case may be infectious where there is no other cause for diarrhoea.
• Isolate resident while you investigate and continue until clear of symptoms for 48 hours.
• Gloves and aprons must be used for all contacts with the resident and their environment.
• Hand washing with a product like Virusan must be done before and after each contact with the resident and environment. Alcohol gel does not work against C diff.
• Test the stool by sending a specimen immediately requesting screening for C diff (within 24 hours if three or more instances of stool type five, six or seven in a 24 hour period) – see Bristol Stool Chart.

What to do if you end up with a C diff outbreak?

Unfortunately, despite your best efforts, you still might end up with a C diff outbreak.

If you do discover that your care home has been hit by an outbreak of C diff then click here to see our Action Plan for Tackling C diff in Nursing Homes. It should help you ensure that any affected residents get back to health as quickly as possible, whilst protecting other care home residents, staff and visitors.

If you are interested in finding cleaning products that are specifically designed to destroy C diff in nursing homes click here.[/cs_text][/cs_column][/cs_row][/cs_section][/cs_content]