The Centers for Disease Control and Prevention (CDC) recently reported that 15 patients in VA facilities were infected with a newly recognized strain of Clostridioides difficile (C. diff) that is highly resistant to clindamycin, an antibiotic that has been used to treat C. diff infections. C. diff is an extremely contagious bacteria that causes life-threatening diarrhea. It is usually a side effect of taking antibiotics.
Persons most susceptible to C. diff infections are—
- People 65 and older who take antibiotics and receive medical care
- People staying in hospitals and nursing homes for long periods of time
- People with weakened immune systems or who have had a previous C. diff infection
It may only be a few days before a person infected exhibits any symptoms. However, it is sometimes several weeks before symptoms occur. Symptoms of C. diff include the following: diarrhea lasting several days, fever, stomach tenderness, loss of appetite, and nausea.
C. diff spreads easily from person to person and the CDC considers C. diff a major health threat. In 2017, there were an estimated 223,900 cases in hospitalized patients and 12,800 deaths in the United States.
Among C. diff infections that have developed because of the new strain, 43 percent were classified as severe in accordance with Infectious Diseases Society of America and Society for Healthcare Epidemiology of America guidelines.
Although the newly identified strain is resistant to clindamycin, it is susceptible to another antibioti—moxifloxacin.
Compliance Perspective
Failure by a nursing home to implement an infection control program capable of identifying serious illnesses affecting its residents may be considered provision of substandard quality of care in violation of state and federal regulations.
Discussion Points
- Review policies and procedures to determine the comprehensiveness of the infection Control Program in light of the CDC warning about Clostridiodes difficile (C. diff), identified as high risk for many residents due to age and frequent use of antibiotics.
- Training staff members on the protocols required to prevent and control infections like C. diff.
- Periodically audit to determine if there are residents displaying symptoms or who have been diagnosed to determine if the Infection Control Program’s protocols are being followed.
