New Look At The Causal Relationship Between Antibiotic Use And C. Difficile Infections

Main Category: Infectious Diseases / Bacteria / Viruses
Also Included In: Seniors / Aging
Article Date: 07 Oct 2008 - 9:00 PDT

email to a friend   printer friendly   view / write opinions   rate article

The latest study by Dr. Sandra Dial from the Research Institute of the MUHC, McGill University, and Attending Staff in the Intensive Care Unit at the Jewish General Hospital, questions the assumption held by a vast majority of medical professionals that Clostridium difficile (C.difficile) infections are essentially always preceded by antibiotic use. This finding could have a major impact on how patients with diarrhea are evaluated upon their admission to the hospital. This study appears in the October 6 issue of the Canadian Medical Association Journal (CMAJ).

The researchers analyzed only C. difficile infections acquired outside the hospital by patients aged 65 or older, and serious enough to require a hospitalization. Patients with hospital-acquired C.difficile infections were excluded because of the increased risk of infection and antibiotic use in the hospital environment.

Their results show that 53% of the patients studied had not been exposed to antibiotics during the 45 days preceding their C.difficile-related hospitalisation. A rate that decreased to 46% when the pre-hospitalization timeframe analysed was extended to 90 days. "These figures show that approximately 50% of community-acquired C. difficile infections are not related to antibiotic use," explained Dr. Dial. "While antibiotic use indeed plays an important role, other factors are likely to also be important. But we still need to determine what these other risk factors are."

More precisely, this study demonstrates that the highest risk of C. difficile infection due to antibiotic use occurs during the 30 days following treatment. According to Dr. Dial, "Beyond the 45-day period following treatment, the risk declines significantly".

"We believe that all patients suffering from diarrhea, particularly if severe enough to require a hospital visit, should be tested for C.difficile at their arrival in the hospital. Right now, testing is mainly done on patients who have taken antibiotics, which probably means that not everyone is receiving a correct diagnosis," warned Dr. Dial.

----------------------------
Article adapted by Medical News Today from original press release.
----------------------------

This release is available in French.

Dr Sandra Dial is the Director of Critical care medicine at the Montreal Chest Institute of the McGill University Health Centre (MUHC), and a researcher within the "cardiovascular diseases and critical care" and the "respiratory health" axis of the Research Institute of the MUHC. She is also an assistant professor at the Faculty of medicine at McGill University.

Click here to access this press release, with the original article and a short audio interview.

The Research Institute of the McGill University Health Centre (RI MUHC) is a world-renowned biomedical and health-care hospital research centre. Located in Montreal, Quebec, the institute is the research arm of the MUHC, the university health center affiliated with the Faculty of Medicine at McGill University. The institute supports over 600 researchers, nearly 1200 graduate and post-doctoral students and operates more than 300 laboratories devoted to a broad spectrum of fundamental and clinical research. The Research Institute operates at the forefront of knowledge, innovation and technology and is inextricably linked to the clinical programs of the MUHC, ensuring that patients benefit directly from the latest research-based knowledge.

The Research Institute of the MUHC is supported in part by the Fonds de la recherche en santé du Québec.

For further details visit: http://www.muhc.ca/research.

About the JGH

Since 1934, the Sir Mortimer B. Davis - Jewish General Hospital, a McGill University teaching hospital, has provided "Care for All," serving patients from diverse religious, linguistic and cultural backgrounds in Montreal, throughout Quebec and beyond. As one of the province's largest acute-care hospitals, the JGH has achieved a reputation for excellence in key medical specialties by continually expanding and upgrading its facilities for clinical treatment and teaching, as well as research at the Lady Davis Institute for Medical Research. For more information, please visit JGH.ca.

For more information please contact:

Rebecca Burns
Communications Coordinator
MUHC Public Relations and Communications

Isabelle Kling
Communications Coordinator (research)
MUHC Public Relations and Communications

Glenn J. Nashen, Director
Reena Kudhail, Communications Specialist
Public Affairs & Communications
Jewish General Hospital

Source: Isabelle Kling
McGill University Health Centre