Hospital pilot halves clostridium infection

The Norfolk and Norwich University Hospital has halved rates of infection from Clostridium difficile in a ground-breaking pilot.

Clostridium difficile is the organism that causes diarrhoea when patients have been on antibiotics for some time. It tends to affect the elderly mainly because this patient population is more frequently exposed to antibiotics for a variety of reasons.

Dr Judith Richards, consultant microbiologist and hospital director of infection control said: “Medicine for the Elderly (MFE) wards tend to see a large number of patients with C.difficile diarrhoea. Because of this, we have an on-going project aimed at reducing the possible environmental and clinical impact of this problem.

Here at the NNUH we used Elsing ward as a pilot site, and by working together with Matron, our Serco cleaning contractors, infection control nurse, ward staff, the housekeepers, and the doctors from the ward, we have managed to reduce the infections by nearly 50%. We are now extending this pilot phase to other MFE wards, to see if we can achieve similar improvements”

C. difficile cases on the pilot ward fell from seven a month to just three a month. C. difficult is a spore forming bacterium which is present as one of the normal bacteria in the gut of up to three per cent of healthy adults and the pilot scheme introduced extended cleaning on the ward to help ensure that spores were removed as disinfectants will not have an effect on them.

The Trust's hospitals have not seen any cases of the more virulent hypertoxin – producing strain recently reported from Canada and other centres in the UK.

Like other Trusts in England, the Trust reports to the Health Protection Agency through a mandatory surveillance scheme on Clostridium difficile. This captures data on laboratory identified infections in patients over the age of 65 years. This surveillance became mandatory in 2004. New national figures, published by the Health Protection Agency, help to monitor trends, and review antibiotic prescribing practices.

Health Protection Agency: C difficile Jan 2004 to Dec 2004

                                                             Rate per 1000 bed days No of C diff cases

Papworth Hospital NHS Foundation Trust           0.5                                13

Hinchingbrooke Healthcare NHS Trust                1                                   73

Peterborough NHS Foundation Trust                 1.1                                166

James Paget Healthcare NHS Trust                 2.33                               289

Ipswich Hospital NHS Trust                                2.36                               402

West Suffolk Hospital NHS Trust                       2.42                               385

Norfolk and Norwich University Hospital          2.47                                499

Cambridge University Hospitals                        3.09                               561

King's Lynn NHS Trust                                        3.55                               432

For more information about Clostridium visit www.nnuh.nhs.uk/clostridium