Source: http://news.bbc.co.uk/2/hi/uk_news/scotland/glasgow_and_west/7464294.stm
'C.diff now a regular occurrence'
By Eleanor Bradford
BBC Scotland's health correspondent
All hospitals in Scotland have been told to review their death rates from Clostridium difficile following the outbreak at the Vale of Leven hospital.
An independent review is to be carried out into why it took so long for the outbreak to be identified, and whether standards at the hospital in Dunbartonshire were up to scratch.
The outbreak first came to light on 22 May when Greater Glasgow and Clyde Health Board revealed there were three cases of the virulent "027" strain at the Vale of Leven.
But it was only in June when the public learned the true scale of the outbreak. On 11 June the health board announced it had looked back over the previous six months and found 54 cases of C.diff.
Eight elderly people had died from the infection and it was a contributory factor in the deaths of a further eight people.
So how could this have gone unreported for so long?
That is now the subject of an independent review, to be carried out by an Aberdeen expert, Professor Cairns Smith. But in the meantime clues may lie in the national statistics already collected.
Alarm bells
According to the Information and Statistics Division of the NHS, in the last three months of 2007 alone there were 1,608 cases of C.diff in Scotland, all of them among over-65's.
Figures collected by the General Register Office for Scotland suggest it was a factor in the deaths of 417 people in 2006, the most recent year for which figures are available.
Clostridium difficile is not uncommon. Its rise has been brought about by the over-prescription of antibiotics, which knock out the body's natural ability to deal with bacteria living in the gut.
The deaths at the Vale of Leven may not have rung alarm bells because Clostridium difficile has now become a regular occurrence in wards caring for the elderly.
Professor Smith's review will establish what lessons can be learned, but will probably echo the conclusions of similar inquiries into other outbreaks.
[/B]In particular, an inquiry into an outbreak in Kent which killed 90 people between 2004-2006 concluded that nurses were too busy to wash their hands.[/B]
The Vale of Leven is not the only hospital dealing with regular outbreaks of C.diff.
It may have dealt with those outbreaks poorly, but only dramatic changes across the whole of the NHS in Scotland will really have an impact on what is clearly a national problem.
Source: http://news.scotsman.com/environment/Deadly-new-strains-of-C.4536283.jp
Deadly new strains of C difficile superbug on the way, warn doctors
Published Date: 29 September 2008
By LYNDSAY MOSS
HEALTH CORRESPONDENT
SCOTLAND must brace itself for an increase in new and severe strains of the Clostridium difficile superbug – and the infection could also become more resistant to the drugs used to treat it, experts have told The Scotsman.
Rising deaths from the bug, which can cause life-threatening illness and spreads easily in hospitals, have prompted concerns about virulent forms of the disease becoming more common in Scotland.
Now experts have predicted that cases involving severe strains could increase further in our hospitals, while new types of the disease are already starting to emerge.
Fears were also raised that C difficile could become less sensitive to the antibiotics currently used to treat it.
Earlier this month, it emerged that the infection was linked to almost 600 fatalities in Scotland in 2007 – up more than 40 per cent on the previous year.
The rise in cases has been linked to the growing prevalence of the 027 strain – or ribotype – of the disease, which first emerged in Scotland in 2006 but which has only become more common in the last year. It has been linked to more severe disease and deaths in patients, and is also thought to be better at spreading around hospitals than other strains.
Professor John Coia, director of Scottish Clostridium difficile Reference Service, said 027 was a concern for the NHS, but it was not the only strain causing death and disease.
He said: "For obvious reasons, people are concerned about 027. But to put it in perspective, I think 106 is something we have to be very aware of as well because it is the commonest type we see."
But while 027 has been the focus of much attention, other new strains are also starting to trouble microbiologists. One type – known as 078 – has recently emerged in Scotland.
In one study, scientists found that 078 was more likely to infect younger patients, but it has not yet been found to be any more severe than other strains.
Prof Coia, a consultant microbiologist at NHS Greater Glasgow and Clyde, said there was concern about 078 picking up resistance to antibiotics which could allow it to spread more easily, like other types.
Dr Anne Eastaway, a consultant microbiologist at Health Protection Scotland, said it was quite possible that new strains of C difficile could start to emerge – and some could be severe in nature.
Professor Ian Poxton, professor of microbial infection and immunity at Edinburgh University, said focusing on any one specific strain of C difficile would not help solve the problem.
"I think the biggest worry at the moment is everyone latches on to 027 and they think that is the only strain that is important," he said. "But certainly from the Edinburgh side, we have a lot of disease and none of it is caused by 027."
Strain is heading for Scotland, and we ignore it at our peril
PREDICTING what will happen next with Clostridium difficile in Scotland is a challenge for scientists and the NHS.
Our main source of information is from other countries. It is fair to say what happens in England and further afield will eventually happen in Scotland, as C difficile is very efficient at travelling around.
So, as they have seen rising rates of the virulent strain 027, we will probably see this continue to rise as well.
But it is not just 027 that we have to worry about. The other more common strains also cause severe and life-threatening disease and we ignore those at our peril.
It is likely that new strains will also appear and that is why it is so crucial that we have a referencing service to detect these strains when they do emerge.
At the moment there appears to be a consensus that the biggest concern is about the 027 strain of C difficile.
I would be surprised if the rise in cases of C difficile we have seen recently was linked to inappropriate use of antibiotics.
But another factor which could play a role in rising C difficile is the ageing population. More and more older people are going into hospital to have their hips done and knees replaced just because they are living longer.
Elderly people are more at risk of getting C difficile than young people. It is also likely that these patients will have had antibiotics at some point because they are more likely to get pneumonia.
To some extent we have to accept that more people are at risk these days.
PROFILE
• Clostridium difficile causes diarrhoea, and in the worst cases can lead to perforation of the intestine – and death.
• The infection is most common in elderly patients with other serious illnesses. Antibiotics can affect the balance of bacteria in the gut, allowing the infection to take hold.
• Although C difficile was first described in the 1930s, it was not identified as the cause of diarrhoea and colitis following antibiotic treatment until the late 1970s
• Between 3 and 5 per cent of the population are thought to carry C difficile in their gut at any one time without becoming ill.
Source: http://www.dailyrecord.co.uk/news/scottish-news/2008/06/20/lives-could-have-been-saved-in-superbug-outbreak-report-reveals-86908-20614069/
Lives could have been saved in superbug outbreak, report reveals
Jun 20 2008 By Magnus Gardham
LIVES may have been saved if guidelines on killer bug C diff had been updated in Scotland.
The scale of a deadly outbreak at Vale of Leven Hospital, Dunbartonshire, only came to light after a health board "lookback" exercise last week.
New reporting guidelines were issued in England in January to ensure cases of clostridium difficile were spotted early and tackled.
But NHS Scotland have so far failed to follow suit - despite a call from Scottish government officials after a meet ing with English colleagues in February.
Yesterday, ministers were under pressure to explain the delay in drawing up new surveillance guidelines.
Labour MSP for Dumbarton Jackie Baillie said: "Why is it that some five months after that meeting on February 14 new guidance covering this infection has not been issued?
"It is highly likely that the advice issued to hospitals in England would be virtually identical and a delay of this magnitude is completely unnecessary.
"It is reasonable to ask whether lives could have been saved if there had not been a delay in issuing clear guidance on C difficile.
"People in Dumbarton and across Scotland need to be assured that the Scottish government are on top of the problem."
The bug has been linked to 17 deaths at Vale of Leven Hospital.
Fifty-four patients have caught it since December and 23 have died. C diff caused eight deaths and played a part in nine others.
A Scottish government spokesman said new guidelines would be put in place following inquiries into the outbreak.
He said reporting guidelines were laid down in 2006 and updated last year.
New advice will be in place by September.
Internal health service documents seen by the Record show an advisory group set up to look at new guidelines met for the first time on June 11.
Health secretary Nicola Sturgeon yesterday rejected grieving relatives' calls for a public inquiry into the Vale of Leven deaths.
She insisted that the investigation she announced on Wednesday would be "no holds barred".
#5:
"Our main source of information is from other countries. It is fair to say what happens in England and further afield will eventually happen in Scotland, as C difficile is very efficient at travelling around. ...
I would be surprised if the rise in cases of C difficile we have seen recently was linked to inappropriate use of antibiotics.
#2: ...
New reporting guidelines were issued in England in January to ensure cases of clostridium difficile were spotted early and tackled.
But NHS Scotland have so far failed to follow suit - despite a call from Scottish government officials after a meet ing with English colleagues in February. ...
#1: ...
According to the Information and Statistics Division of the NHS, in the last three months of 2007 alone there were 1,608 cases of C.diff in Scotland, all of them among over-65's.
Figures collected by the General Register Office for Scotland suggest it was a factor in the deaths of 417 people in 2006, the most recent year for which figures are available.
Clostridium difficile is not uncommon. Its rise has been brought about by the over-prescription of antibiotics, which knock out the body's natural ability to deal with bacteria living in the gut. ...
In particular, an inquiry into an outbreak in Kent which killed 90 people between 2004-2006 concluded that nurses were too busy to wash their hands."
Another deadly illness.
Shamefully for these nurses to became an deadly illness vector (as an alternative to washing they can put on new gloves for every diferent patient), their managers who didn't employ more nurses (even part-time) to slow down the working rush, and instaurate new guideliness.
Source: http://ukpress.google.com/article/ALeqM5gwK3BEDG064i4oRVELIgv45dpiGw
Hospital bug death roll rises
42 minutes ago
The death toll in an outbreak of the C. difficile bug at a hospital has risen to nine, officials said.
A rechecking of records has revealed that a patient already known to have the bug has died, said the officials.
The Clostridium difficile hospital bug was the main cause of death, taking to nine the total number of deaths linked to the outbreak at the Vale of Leven Hospital in Alexandria, West Dunbartonshire.
Source: http://www.eveningtimes.co.uk/news/display.var.2359897.0.death_toll_hits_18_at_c_diff _hospital.php
Death toll hits 18 at C.diff hospital
ANOTHER patient has died at a hospital hit by Clostridium difficile, taking the toll to 18.
The latest victim died in the Vale of Leven Hospital in Alexandria. NHS Greater Glasgow and Clyde today said the patient was seriously ill from an unrelated condition, and while C.diff was a contributory factor, it was not the main cause of death.
Nine people have now died at the hospital with C.diff cited as a contributory factor. The superbug has been listed as the main cause of death in another nine cases.
Dr Syed Ahmed, chairman of the outbreak control team, said: "I would like to express my deepest sympathies to the family of this patient."
In a separate outbreak, a ward at Glasgow's Victoria Infirmary remains closed to new admissions after four patients tested positive for C.diff.
Publication date 24/06/08
 I could use some help again...
 Lost Licences |
Scotland: 'C.diff now a regular occurrence'