Medics take fight against killer bug to communities

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SCOTLAND’S health professionals are entering a new phase in their battle against the deadly Clostridium difficile bug, targeting cases in the community to trigger a fresh downward trend.

Despite a sizeable fall in the incidence of the infection across Scotland as a whole in recent years, new figures show significant rises in some parts of the country in the last year.

Now health officials are to focus attention on the many strains of C difficile found in patients outside of hospitals, where infection control measures are harder to implement.

A number of projects have been launched to try to deal with these community cases, the Scottish Government says.

In its last quarterly report, Health Protection Scotland (HPS) revealed a year-on-year drop in rates of C difficile of 10 per cent in those aged 15 to 64 and 2 per cent in the over 65s, who are most at risk from the stomach bug.

The report also warned that some NHS boards had seen significant increases compared to the previous year, which they said was a “reminder that there is scope for further reductions”.

Figures obtained by The Scotsman revealed that three boards saw rates rise last year.

NHS Fife saw cases in over-65s increase from 21.2 cases per 100,000 hospital bed days in 2011 to 31.9 per 100,000 last year.

Among cases in patients aged 15 to 65, NHS Forth Valley saw its rate per 100,000 bed days increase from 7.3 to 22.8. In NHS Highland it rose from 33.3 to 56.4.

Dr Camilla Wiuff, strategic lead for microbiology at HPS, said: “We have a reached a plateau, you can say, or a valley. Rates are not coming down so rapidly overall.”.

Dr Wiuff said that infection control measures in hospitals and careful use of antibiotics – some of which can increase the risk of C difficile – had been successful in eradicating some strains of the bug.

But she said those that remained were proving more difficult to tackle as they seemed to stem from patients in the community rather than in hospitals.

“We don’t really know where they come from. The research has not been done yet, but there are suggestions around animals and food products,” she said.

Margaret Watt, chair of the Scotland Patients Association, said C difficile must not be allowed to get out of control again and expressed concern over rising rates in some areas.

“We need to make sure standards of cleanliness are being kept high,” she said.

The health boards which saw rising rates of C difficile said these were often the result of a rise in a small number of cases exaggerating the rates or changes to the way they tested for infections.

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