Clostridium difficile Blog : Clostridium difficile Lawyer & Attorney : Marler Clark Law Firm : C. difficile Blog

As we’ve been following both Clostridium difficile (C. diff) and Meticillin Resistant Staphylococcus Aureus (MRSA), we’ve noted that both Superbugs get a lot of attention in the United Kingdom.

We are not sure if this is ever going to figure into the big health insurance reform debate in the United States, but public hospitals in England and Scotland appear to be places you might want to avoid if you want to escape both C. diff and MRSA.

For example, the ”Registrar General” in Scotland just reported that C diff claimed the lives of 248 last year, up 12.7 percent. What they call “the hospital infection” contributed to the deaths of another 517 Scots.

MRSA killed another 48 Scots in 2008, down 8 percent from the year earlier.

Last year started with a C. diff outbreak at the Vale of Leven Hospital in Dunbartonshire, causing death rates to peak in the first half of the year, and then decline some.

That was “cautious grounds for optimism,” according to Health Secretary Nicola Sturgeon, but not a reason to be complacent. The government is installing “an electronic bed management system” and “infection tracking software” to combat the Superbugs in the public hospitals.

• Email This
• Print
• Comments
• Trackbacks
• Share Link

 This just in from across the pond:

"In England and Wales, the national health statistics in 2007 showed that there were 8,324 death certificates which named Clostridium difficile. This is a bacterium which causes severe diarrhoea in humans and animals as the underlying cause of death, a 28 percent increase from 2006."

Janet Nale of the Department of Infection, Immunity and Inflammation has been investigating the contributing factors that make Clostridium difficile so aggressive to direct treatment.

She will present her research at the Festival of Postgraduate Research tomorrow on Thursday, June 25th in the Belvoir Suite, Charles Wilson Building at the University of Leicester between 11:30 am and 1 pm. This event is open to the public and is free to attend.  We will be looking for what she has to say.

• Email This
• Print
• Comments
• Trackbacks
• Share Link

The BBC is reporting that two elderly patients suffering from Clostridium difficile  have died at Dr. Grey's hospital in Moray, Scotland.

Six other patients at the hospital have contracted Clostridium difficile.  Additionally, a higher than usual number of patients are suffering from gastrointestinal illnesses.

An outbreak control team has been set up.

The health board said the deaths happened in April and that both the patients had been frail.

A spokesman said the infection was the main cause of death in one of the patients and was a contributory factor in the second death. 

More information is in the BBC article.

• Email This
• Print
• Comments
• Trackbacks
• Share Link

I had a chance to chat with Larry Smith, who publishes the Bulletproof Blog. Each week Larry interviews top plaintiffs’ attorneys for their perspective on the crises likely to affect businesses in the near future.  Here's how he described our interview:

In this issue, we talk to Bill Marler of the Seattle-based Marler Clark, LLP PS. He is the legal profession’s best-known advocate for plaintiffs in food-related cases and a major force for food safety in the U.S. During his career, Mr. Marler has secured nearly $500 million for his clients. He publishes widely and speaks on food safety around the world.

Here's where C. diff came up:

Larry Smith: Are there specific products that you now have your eye on?

Bill Marler: It’s hard for anyone to predict the next crisis because we’re talking about ever-morphing pathogens. I have nothing but empathy for responsible companies challenged to somehow predict the next bacterium and where it’s going to strike. To cite just a couple of danger zones, pork products face increased risk of Methicillin-resistant Staphyloccus aureus (MRSA) bacteria and, as we effectively control Salmonella, we create opportunites for Clostridium difficile (C-dif) bacteria to proliferate in our guts. It’s a deadly threat to the elderly.

The entire interview can be read here.

• Email This
• Print
• Comments (1)
• Trackbacks
• Share Link

You would think we'd have enough pathogens to lose sleep over, but it seems that there is at least one more to add to the midnight pantheon.  Over the last several years we have seen multiple instances where Clostridium difficile and foodborne illness have been related. However, the Clostridium difficile infection has generally been associated with the foodborne illness after treatment for the infection by antibiotics, not as a result of actual ingestion of the Clostridium difficile bacteria. However, in the recent Salmonella Typhimurium Peanut Butter outbreak, we have two cases where children seem to be co-infected with both Clostridium difficile and Salmonella Typhimurium. Which brings us to the the important question – Is Clostridium difficile foodborne?

For background, Wikipedia reports that Clostridium difficile is a species of Gram-positive bacteria of the genus Clostridium. Clostridia are anaerobic, spore-forming rods (bacillus). C. difficile is the most serious cause of antibiotic-associated diarrhea (AAD) and can lead to pseudomembranous colitis, a severe infection of the colon, often resulting from eradication of the normal gut flora by antibiotics. The C. difficile bacteria, which naturally reside in the body, become overgrown: The overgrowth is harmful because the bacterium releases toxins that can cause bloating, constipation, and diarrhea with abdominal pain, which may become severe.

The CDC reports that mortality rates from Clostridium difficile disease in the United States increased from 5.7 per million population in 1999 to 23.7 per million in 2004. Increased rates may be due to emergence of a highly virulent strain of C. difficile.

Here are a few articles that I have found or have been sent on the topic. Clearly more research needs to be done.

Possible Seasonality of Clostridium difficile in Retail Meat, Canada (pdf)

Rodriguez-Palacios A, Reid-Smith RJ, Staempfli HR, Diagnault D, Janecko N, Avery BP et al. Possible seasonality of Clostridium difficle in retail meat, Canada. Emerg Infect Dis. 2009 May

We previously reported Clostridium difficile in 20% of retail meat in Canada, which raised concerns about potential foodborne transmissibility. Here, we studied the genetic diversity of C. difficile in retail meats, using a broad Canadian sampling infrastructure and 3 culture methods. We found 6.1% prevalence and indications of possible seasonality (highest prevalence in winter).

Clostridium difficile in Retail Meat Products, USA, 2007 (pdf)

Songer JG, Trinh HT, Killgore GE, Thompson AD, McDonald LC, Limbago BM. Clostridium difficile in retail meat products, USA, 2007. Emerg Infect Dis. 2009 May

To determine the presence of Clostridium difficile, we sampled cooked and uncooked meat products sold in Tucson, Arizona. Forty-two percent contained toxigenic C. difficile strains (either ribotype 078/toxinotype V [73%] or 027/toxinotype III [NAP1 or NAP1-related; 27%]). These findings indicate that food products may play a role in interspecies C. difficile transmission.

Clostridium difficile in Ready-to-Eat Salads, Scotland (pdf)

Bakri MM, Brown DJ, Butcher JP, Sutherland AD. Clostridium difficile in ready-to-eat salads, Scotland. Emerg Infect Dis. 2009 May

Of 40 ready-to-eat salads, 3 (7.5%) were positive for Clostridium difficile by PCR. Two isolates were PCR ribotype 017 (toxin A–, B+), and 1 was PCR ribotype 001. Isolates were susceptible to vancomycin and metronidazole but variably resistant to other antimicrobial drugs. Ready-to-eat salads may be potential sources for virulent C. difficile.

• Email This
• Print
• Comments (1)
• Trackbacks
• Share Link

A potentially deadly intestinal germ increasingly found n hospitals is also showing up in a more unsavory setting: grocery store meats.  According to press reports this morning, an Arizona researcher found that a shocking forty percent of tested meat products were contaminated with Clostridium difficile, a bacteria normally associated with severe hospital infections. The test was conducted on meat from three national chain stores.  Federal health officials, however, say more study is needed to determine whether C. diff is transmitted through food.

 More than 40 percent of packaged meats sampled from three Arizona chain stores tested positive for C. diff., according to newly complete analysis of 2006 data collected by a University of Arizona scientist. Nearly 30 percent of the contaminated samples of ground beef, pork and turkey and ready-to-eat meats like summer sausage were identical or closely related to a super-toxic strain of C. diff blamed for growing rates of illness and death in the U.S. — raising the possibility that the bacterial infections may be transmitted through food.

• Email This
• Print
• Comments
• Trackbacks
• Share Link