The Association for Professionals in Infection Control and Epidemiology reports that more hospital patients get sick with deadly, diarrhea-causing germs than previously believed. The findings were disclosed at the group’s annual conference and will be published in the American Journal of Infection Control.

To be more specific, as many as 13 out of every 1,000 hospital patients are infected with Clostridium difficile on any one day, William Jarvis, a researcher who led the study for the  Association of Professionals in Infection Control and Epidemiology.  “The burden of C. difficile is much greater than anyone had expected,” Jarvis added.

C. difficile is a bacterium that causes diarrhea and more serious intestinal conditions such as colitis. Infections with this bacterium may result in more serious intestinal conditions, sepsis and rarely death. Symptoms of such infections include watery diarrhea (at least three bowel movements per day for two or more days), fever, loss of appetite, nausea and abdominal pain or tenderness. The treatment includes antibiotics for 10 days. People who are hospitalized are at great risk of being infected with C. difficile. Older patients and those with weaker immune systems are also at risk.

The study, the first to look at C. difficile in hospitals, found that more than $7,000 patients are being treated for the disease every day. The findings are based on research of APIC’s 12,000 members who collected data about all of diagnosed C. difficile patients on one day between May and August 2008 at 648 hospitals. Their study covered 12.5 percent of all US medical facilities including acute care, cancer, cardiac, children’s and rehabilitation hospitals.

The figures are closer to what the US Centers for Disease Control and Prevention previously estimated: as many as 500,000 people are infected with C. difficile each year, Cliff McDonald, a CDC epidemiologist in the division of health care quality promotion, said. The CDC had estimated 291,000 hospital stays from the germ in 2005, and 134,000 in 2000.

In most cases, C. difficile disease develops after cross infection from another patient, either through direct patient to patient contact, via healthcare staff, or via a contaminated environment. A patient who has C. difficile diarrhea excretes large numbers of the spores in their liquid feces. These can contaminate the general environment around the patient's bed (including surfaces, keypads, equipment), the toilet areas, sluices, commodes, bed pan washers, etc. They can survive for a long time and be a source of hand-to-mouth infection for others.

There are three important components to the prevention and control of C. difficile disease: 1. prudent antibiotic prescribing to reduce the use of broad-spectrum antibiotics; 2. isolation of patients with C. difficile diarrhea and good infection control nursing (handwashing and wearing gloves and aprons, especially when dealing with bed pans); 3. enhanced environmental cleaning and use of a chlorine containing disinfectant where there are cases of C. difficile disease to reduce environmental with the spores.