Physician Practice

C. diff infections linked to medical clinics

Physician Practice Insider, May 5, 2015

Healthcare-associated infections have been getting attention for some time now, and you've likely been taking measures to protect your patients and employees. But infection control experts are warning that a particularly troublesome infection is more prevalent than once thought, and that medical offices may now become a breeding ground for C. diff outbreaks.

The prevalence of Clostridium difficile, or C. diff, a bacterial infection of the gastrointestinal system primarily found in hospitals, is much higher than once thought, affecting up to 500,000 people annually, according to a February 25 report from the CDC that was published in the New England Journal of Medicine.

Perhaps even more disturbing is the study's revelation that up to 150,000 people who had not previously been in the hospital came down with C. diff in 2011. Of those, about 80% had visited a doctor's or dentist's office in the 12 weeks before their diagnosis. In a 2013 examination of outpatient medical clinics in Ohio, researchers found C. diff spores present in six out of seven clinics, including on chairs and examining tables in waiting rooms and patient treatment areas. CDC officials say the revelation is so concerning that they're starting a series of case control studies to try to assess nationally whether people are getting C. diff infections in medical offices.

The latest CDC revelation means that C. diff is being found, and perhaps transmitted, in healthcare facilities previously thought safe from the bug. In the past, it was thought that clinics were generally safe from C. diff because of the quick turnover of patients and the fact that generally sicker—and longer-term—patients are seen at hospitals.

"[Patients] are probably coming in having been exposed in hospitals," says Peggy Prinz Luebbert, MS, MT (ASCP), CIC, CHSP, creator of IP-Bootcamp, and president and founder of Healthcare Interventions, in Omaha, Nebraska. "It's one of those organisms that once you have it, you are always going to be colonized with it. You could potentially transmit it to people who have not been colonized due to their risk factors at home on an outpatient basis."

In other words, that patient in the doctor's office who is on antibiotics and waiting to get checked for a bout of diarrhea, but is not aware of the infection, could theoretically transmit C. diff spores to patients also waiting to get checked for flu symptoms or a common cold.

This article is excerpted from Medical Environment Update.

Most Popular