A bacterial infection that causes chronic diarrhea and fever, among other symptoms, is on the rise, experts say. Since 2000, the incidence has increased 25 percent a year. Paradoxically, the chief cause: the very drugs designed to fight off bacterial infections, antibiotics.

The intestinal bug called Clostridium difficile flourishes when antibiotics disrupt populations of benign bacteria that normally reside in the gut, where they help break down food, allowing the bad bug to take over. Unfortunately, C. difficile itself has become increasingly resistant to antibiotics. It’s also become far more toxic, research suggests. In a 2003 outbreak in Quebec, cases of C. difficile increased almost four-fold and deaths associated with the infection increased more than 10-fold compared with the previous year.

“I wouldn’t wish this illness on anybody. C difficile is one of the most terrible things that I’ve been dealing with in my whole life, and I’ve dealt with a lot of things…”

The words are those of a 76-year-old patient, identified as Mr. S., who was quoted in a recent issue of the Journal of the American Medical Association. Mr. S’s problems began when he was given two powerful antibiotics to treat a urinary tract infection. Shortly after he was discharged from the hospital, he began to suffer bouts of diarrhea. After several weeks, he was given another antibiotic to treat C. difficile. He recovered briefly, only to develop diarrhea again, along with loss of appetite, fever, chills, and weakness. Tests showed that he was still infected with C. difficile. Doctors prescribed an alternate antibiotic. It, too, failed to stem the infection. In the months that followed, Mr. S. had to be hospitalized several times for diarrhea. Even now, although intensive antibiotic treatment has eased his symptoms, it’s not clear he is rid of the stubborn bug.

Like Mr. S., most people are probably exposed during stays in the hospital. Between .5 and 1 percent of hospital stays end up exposing patients to the bacterium. All told, 350,000 Americans each year develop the infection after being hospitalized. Many others are infected in nursing homes and other health care facilities. Small wonder. The bacterial spores can withstand drying, fluctuations of temperature, and even many antibacterial solutions. Remaining viable for long periods, the spores cause infection when ingested. All you have to do is eat or drink from a contaminated container, in other words–or touch a contaminated surface and then your mouth–and become infected.

The bug can pass from person to person, putting people who share a household with someone who carries the bacterium at increased risk. Only about 20 percent of infections take place outside of health care facilities, studies suggest.

Although infections can usually be eliminated with powerful antibiotics that target C. dfficile, many patients develop recurring infections. In extreme cases, when the infection becomes life-threatening, doctors have to remove the intestines in order to eliminate the germ.

In the face of the rising threat of C. difficile, health care experts say hospitals and other medical facilities need to do more to cotrol its spread. If you visit a friend or family member in a medical facility, be vigilant about hand washing and avoid touching surfaces unless necessary. Using antibiotics only when they’re necessary could also help lower the risk of infections. If you develop severe diarrhea after taking a course of antibiotics, call your doctor immediately.

© 2009 PDQhealth

Tags: antibiotics, Clostridium difficile