GUIDELINES FOR dealing with the hospital bug Clostridium difficile (C-diff) must be updated following the emergence of a new, highly infective strain, the European Centre for Disease Prevention has said.
Dr Fidelma Fitzpatrick, consultant microbiologist with the Health Protection Surveillance Centre, confirmed that updated guidelines are in place for the Republic. "Our guidelines are in sync with the European ones," she said last night.
Although C-diff only became a notifiable disease here earlier this year, the latest figures, based on reports from seven acute hospitals and two nursing homes, show that 81 of the 350 cases analysed were of the highly virulent 027 strain of the infection.
There have been a number of confirmed outbreaks of C-diff infection in hospitals in the State. An outbreak at Ennis General Hospital in 2007 contributed to 13 patient deaths.
C-diff was also the cause of death or a contributing cause of death in 10 patients at St Colmcille's Hospital, Loughlinstown, Dublin, over a seven-month period last year.
Most patients in a medical ward for older patients who were affected by C-diff infection in January at Galway's University College Hospital (UCH) were found to have the highly transmittable 027 strain of the bacteria.
Some 30 per cent of patients who became infected died within 30 days, although Prof Martin Cormican of the Department of Medical Microbiology at UCH emphasised the deaths were from "all causes" and not necessarily as a result of C-diff infection.
The bug is found in the intestines of 3 per cent of healthy adults. It causes disease in vulnerable patients, many of whom are taking antibiotics for other medical conditions.
A severe form of C-diff infection called pseudomembranous colitis occurs in older people and those with pre-existing diseases.
"ECDC has recognised this emerging new disease and undertaken several actions to inform all EU member states," Zsuzsanna Jakab, the director of the European Centre for Disease Prevention and Control (ECDC), said yesterday.
The report recommends that all EU member states are aware of C-diff in healthcare facilities, and pay particular attention to the 027 strain.
"Evidence-based guidelines to prevent the spread of C-diff should combine early diagnosis, surveillance, education of staff, appropriate isolation precautions, hand hygiene, use of protective clothing, environmental cleaning and cleaning of medical equipment, good antibiotic stewardship and specific measures during outbreaks," it said.