Mountain View Voice

News - June 3, 2011

El Camino steps up fight against deadly disease C. diff

C. diff is a common, low-profile, potentially deadly disease

by Nick Veronin

A difficult-to-pronounce disease commonly found in nursing homes and hospitals is a growing problem, according to a Mountain View health official.

Dr. Eric Pifer, chief medical officer for El Camino Hospital, said that Clostridium difficile, a bacterial infection that causes diarrhea, fever, bowel irritation, and in severe cases has been known to be fatal, has become more prevalent in hospitals around the country — a trend he attributes to excessive use of antibiotics and certain heartburn medications.

"The bacteria seems to have gotten stronger — more virulent," Pifer said.

Clostridium difficile, or "C. diff," is virtually impossible to eliminate in the hospital setting, Pifer said, though he is confident he can bring infection rates down significantly at El Camino with his latest campaign against the disease.

The disease is contracted when a person ingests the bug, which originates in human waste and is most commonly transferred first to patient's hands or the hands of a caretaker during a trip to the restroom. Without adequate hand washing, the bacteria on can easily make its way into the mouth.

Pifer aims to bring down cases of C. diff at El Camino through a three-pronged attack: by raising awareness of the disease, by pursuing a rigorous protocol of disinfecting the rooms of patients diagnosed with C. diff and by pushing doctors in the hospital to be more prudent about prescribing antibiotics and proton pump inhibitors — the active ingredient in some drugs such as Prilosec that are used to treat heartburn, ulcers and stomachaches.

Controlling the administration of antibiotics and proton pump inhibitors within the hospital shouldn't be too difficult, Pifer said. However, the hospital can do little to prevent primary care physicians in outside clinics and at nursing homes from doling out such drugs, which Pifer said deplete the friendly, naturally occurring bacteria in humans' intestinal tract and open the door first for diarrhea and ultimately increase the chance of a patient contracting C. diff.

"As a society, our physicians prescribe way too many antibiotics," Pifer said, adding that proton pump inhibitor medications are prescribed far too frequently to patients who would be able to eliminate their heartburn and stomach pain if their primary care doctor simply advised them to modify their diet.

"It's pretty common for doctors to prescribe antibiotics for bronchitis or a sinus infection, when in most case the patient doesn't need those drugs," Pifer said. "People don't like to hear that; they like to go home with a prescription."

Pifer said that it is difficult to quantify with hard data, but he suspects that a large number of the cases of C. diff he sees at El Camino are created, at least in part, by seniors who are on a regimen of proton pump inhibitors before entering the hospital.

Although Pifer said that rates of C. diff are low at El Camino Hospital, he believes that Clostridium difficile is something that the community at large needs to be aware of, and both doctors and patients have a role to play in helping bring the rates of the disease down.

As consumers, patients can avoid taking over-the-counter versions of proton pump inhibitor medications. Primary care doctors should also be aware of the risk these drugs pose and exercise restraint when prescribing antibiotics.

Pifer said that he doesn't want to blow the issue of C. diff out of proportion. He noted that antibiotics save many lives each year and that there are relatively few dangerous side effects to proton pump inhibitor medications.

All the same, "People die of this infection. It's a serious health threat," he said.

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