Transcript Current Threats to Public Health C. difficile

Clostridium difficile and other Superbugs
What is it?
 Clostridium difficile are
rod shaped, anaerobic,
gram positive bacteria
that naturally grow in
our intestines.
 They become a problem
when they overpopulate
our intestines and drive
other helpful bacteria
out.
What is it?
 The overpopulation is
harmful because these
bacteria can release
toxins that can cause
bloating, constipation
and diarrhea.
 They are the number one
cause of antibiotic
associative diarrhea in
hospitals and long-term
care facilities.
What are the symptoms?
 The major sign of a C.
difficile infection is
major diarrhea.
 It is usually accompanied
by abdominal pain.
 Each patient has had
exposure to antibiotics
previous to the onset of
symptoms.
How does one develop a C. difficile
infection?
 Use of broad spectrum
antibiotics to fight off
another bacterial disease
or to prevent infection
after surgery kill off
normal bacteria that
grow in your gut and C.
difficile takes over.
How is it transmitted?
 C. difficile bacteria are
found in feces.
 People can get infected if
they use their hands to
touch surfaces
contaminated with feces,
and then touch their
mouths or eyes.
 Healthcare workers can
spread the bacteria to their
patients if their hands are
contaminated.
Who is at risk?
 Healthy people don’t
usually get C. difficile.
People who have other
illnesses or conditions
requiring the use of
antibiotics and the
elderly are at greater risk
of infection.
Why should we be concerned?
 C. difficile is resistant to
most antibiotics.
 It is the start of what
many scientists believe
will be a string of
antibiotic resistant
bacteria.
 In some cases the
dehydration caused by C.
difficile can be fatal.
When did it become a problem?
 In June of 2003, it was
diagnosed in hospitals in
Calgary and Montreal.
 By the end of 2004, 1400
cases were documented
(mainly in Quebec) and 89
people died.
 In 2005 it showed up in the
Toronto area and
outbreaks have been
recorded every year since at
hospitals or long-term care
facilities.
What was PHAC’s response?
 PHAC has been surveying hospitals and long-term
care facilities since 2003.
 It has put out a guideline for C. difficile.
 It has put into place, guidelines for healthcare workers
and laboratory workers for dealing with infectious
patients and biohazardous materials (i.e. feces).
How do we protect ourselves from
getting C. difficile?
 As with any infectious disease, frequent hand-washing is
one of the best defenses against the spread of C. difficile.
 If you work or visit a hospital or long-term healthcare
facility, wash your hands often, especially after using the
toilet. Most healthcare facilities provide an alcohol-based
hand sanitizer at the entrance. Be sure to use it. If your
hands are visibly soiled, use soap and water to wash them
instead of an alcohol-based hand sanitizer.
 Saccharomyces boulardii (a yeast found in lychee fruit) is
the only probiotic worldwide known to diminish levels of
C. difficile in the body (OptiBac Probiotics).
What happens if I already have a C.
difficile infection?
 If the symptoms are mild,
you may need no
treatment, just wait out the
return of the healthy
bacteria back to your gut.
 If it is more severe,
treatment with antibiotics
is needed (i.e.
Metronidazole)
 If left untreated,
perforated bowels may
require surgery!
Other “Super Bugs”
 VRE: Vancomycin Resistant
Enterococcus
 Can cause urinary tract
infections and various nasty
things including meningitis.
 MRSA: Methicillin Resistant
Staphylococcus aureus.
 Skin and soft tissue can
become infected and pus
filled boils and holes can
occur
 Can lead to “flesh-eating”
disease and toxic shock.
VRE destroying lung tissue
Other “Superbugs”
 More and more “superbugs” are
appearing due to the overuse
and misuse of antibiotics.
 Strains of bacteria that cause
gonorrhea and tuberculosis are
showing multi-drug resistance.
 Many opportunistic bacteria
such as Pseudomonas
aeruginosa are becoming more
and more difficult to treat!
 Now we are turning to other
types of treatment and therapy
rather than antibiotics in the
hopes of reducing the
appearance of “superbugs”.