Eight patients die in outbreak of superbug at hospital

THE deaths of eight patients at a hospital from the Clostridium difficile "superbug" in the past six months have triggered calls for a re-examination into hospital procedures.

The Vale of Leven Hospital, in Alexandria, West Dunbartonshire, had to treat 54 patients with the C diff bug during December to June this year, 41 of whom contracted the infection following admission.

The eight who died were all elderly patients and yesterday NHS Greater Glasgow and Clyde Health was criticised for failing to properly tackle the virus.

Releasing a report into the outbreak, the health board said that in eight cases, C diff was believed to be the main cause of death.

However, in another eight deaths, the bug was found to have been a contributory factor, while a further six patients with the infection also died, though the board said C diff played no role in these cases.

The outbreak was uncovered following the discovery of three cases of the 027 strain in the Clyde area, which raised fears that it may have been spread from Vale of Leven to the Royal Alexandra Hospital in Paisley.

The subsequent investigation revealed "that a high number of elderly patients died" – particularly those who had been prescribed antibiotics – at the Vale of Leven during the first part of this year.

There are currently only three patients in the hospital with the bug and all are being treated in isolation, the board added.

The board's public health protection unit yesterday held an outbreak control meeting to discuss its response to the deaths. It agreed a series of measures including a review of the use of antibiotics.

Dr Syed Ahmed, chairman of the outbreak control team, said: "The overall number of C diff cases within the six-month period is higher on average than we would expect and we are particularly concerned about the number of deaths due to this infection."

Professor John Coia, a consultant microbiologist and director of the National C diff Reference Service, said a reduction in the use of antibiotics had to be re- examined.

And Professor Hugh Pennington, emeritus professor of bacteriology at the University of Aberdeen, said the outbreak would change the way people dealt with C diff.

He said: "Unfortunately, we always seem to need some sort of event like this just to get it up on to the screen. It's been there, people have been working very hard on tackling C diff, but it still requires politicians, hospital managers and workers to say, 'Whatever else, if somebody comes into a hospital they should go out no worse than they came in'."

The Lib Dem health spokesman, Ross Finnie, criticised the health board, claiming it was failing to manage the problem properly.

"They found that eight patients had died from C diff," Mr Finnie said. "That doesn't sound like better detection, but rather a complete failure of the health board to stay on top of virus control."

Margaret Watt, chairwoman of the Scotland Patients Association, said the outbreak showed people's fears about going into hospital were well grounded.

Q&A: Old age and antibiotics raise risk factor

What is Clostridium difficile?

It is a bacterium that causes diarrhoea as well as more serious intestinal infections.

Who is most at risk?

People who require prolonged use of antibiotics, and the elderly.

Why are the elderly worst affected?

Children are born with the bug but are unaffected, and it decreases with age. In old age the bug returns, this time with potentially lethal results.

How does it compare with other so-called 'superbugs'?

There were 1,652 deaths in the UK from MRSA in 2006, and 6,480 killed by C difficile, a rise of 72 per cent over 2005.

What is the Scottish Government doing?

At the beginning of the month, Nicola Sturgeon, the health secretary, announced all patients are to be tested for MRSA on admission and treated if necessary. A hand-hygiene campaign and reporting system has been established.

How long have we known about C difficile?

Though it has been known for a long time, it was first identified as a hospital problem during the 1960s, but only became a major issue in the 1970s, when antibiotic use became much more widespread.

Is it possible that C difficile can be eradicated completely.

No, unlike MRSA, which is a hospital-bound condition, its spores exist in the environment naturally. However, it is possible to minimise its effects.