The somewhat reassuring news is that it’s unlikely that “people will be dropping dead of C. diff in the streets,” says lead researcher Marya Zilberberg, MD, of the University of Massachusetts.
The not-so-reassuring news is that this germ is getting more serious. C. difficile causes watery diarrhea, fever, loss of appetite, and abdominal pain, as well as a more serious life-threatening inflammation of the intestines called colitis, according to the Centers for Disease Control and Prevention.
Dr. Zilberberg and her colleagues found a 23% rise in C. diff hospitalizations each year between 2000 and 2005. Cases most commonly occur in older, sick patients who have been taking antibiotics.
The new study showed a doubling of the number of cases in people over 45 (they also increased in those ages 18-44, but to a lesser extent). Overall, the number of adults with the infection increased from 134,361 in 2000 to 291,303 in 2005.
“If you get an antibiotic for some other ailment—for pneumonia, say—other bugs that keep it down die off in response to the antibiotics,” says Dr. Zilberberg. “This one takes over, and there are certain strains that can wreak havoc with your gut.”
In the study, the case-fatality rate—the percentage of people infected with the bacteria that die—increased from 1.2% to 2.3%. Dr. Zilberberg says that some of the those people may have died of other causes but just happened to be infected with C. difficile at the time. In comparison, people hospitalized with pneumonia have a case-fatality rate of 4% to 5%, she said.
But the CDC’s Cliff McDonald, MD, PhD, says the germ has a case-fatality rate of about 6% in some hospital outbreaks (and in one case, as high as 15%).
There’s a specific strain of C. diff, called NAP1, that may be behind the higher fatality rate, says Dr. McDonald, a medical epidemiologist. And there are some signs that it’s getting more difficult to treat.
“Should be we concerned? Yes, we are concerned,” he says.
What to do about it? To avoid C. difficile, your best bet is to steer clear of antibiotics unless they are truly necessary.
“Antibiotics are lifesaving when necessary; I don’t want to close the door on antibiotics,” says Dr. Zilberberg. However, they should be used in a “sober and judicious way,” she says.
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