Superbug linked to 600 deaths in a year

Published on Tuesday 16 September 2008 22:11

DEATHS linked to the Clostridium difficile superbug soared in Scotland last year, figures revealed yesterday.

The deadly infection was involved in almost 600 fatalities in 2007 – up more than 40 per cent from the previous year.

And C difficile was the main cause of death in 220 of these cases, compared to 164 in 2006.

Campaigners said the figures proved the superbug was "running amok" in hospitals.

Experts said part of the reason for the rising incidence of C difficile was a particularly deadly strain which took hold in Scotland in the past year.

It comes after an outbreak at the Vale of Leven Hospital in Dunbartonshire, where it infected 55 patients and was linked to 18 deaths.

The General Register Office for Scotland said that C difficile was mentioned on 597 death certificates last year – on 220 as the underlying cause of death and 377 as a contributory factor.

The number of deaths in which C difficile was the main cause rose 34 per cent between 2006 and 2007 – more than double the 102 cases in 2005.

Cases where C difficile was a contributory factor also rose by almost 50 per cent, from 253 in 2006 to 377 last year. NHS Greater Glasgow and Clyde, which covers Vale of Leven and is Scotland's biggest health board, had the most C difficile-related deaths, at 180.

Experts said increased awareness and recording were not the only factors behind rising rates.

Dr Ian Gould, a consultant microbiologist at NHS Grampian and president of the Scottish Microbiological Association, said more virulent strains of C difficile, including "027", were a factor in the rising death rate.

But he said cleaning regimes and the increased use of alcohol hand gels – which are effective against MRSA but not C difficile – were also a factor.

"There should be more widespread use of disinfectants in hospitals as research suggests these are more effective than normal detergents in combating infections," Dr Gould said.

The leading microbiologist Professor Hugh Pennington said the ageing population could also be contributing to the increase, as C difficile was most common among the elderly.

Michelle Stewart, whose mother-in-law, Sarah McGinty, 67, died in the Vale of Leven outbreak, said she was not surprised by the rising figures.

"It is running amok in hospitals which is why we have been calling for a public inquiry," she said. "The Vale of Leven is not the only hospital where C difficile is a problem."

The health secretary, Nicola Surgeon, said the government did not underestimate the scale of the problem.

So what can we do to tackle C difficile?

RISING rates of Clostridium difficile in our hospitals are to some extent the result of greater awareness and increased recording of the infection, writes Professor Hugh Pennington.

But it would be unwise to say it was only down to better recording. There is a consensus that the 027 strain of C difficile is nastier than its predecessors. You would expect that, as this strain gets commoner and more well established, which it has, that you would see more deaths as a consequence.

But another factor that could play a role is the ageing population, because the elderly are most at risk.

There is no single answer to reducing C difficile in our hospitals. Putting everyone in single rooms would definitely help. That is the ideal we should be aiming for. With the new Southern General in Glasgow being built with all single rooms, we are going in the right direction, just not fast enough.

Improving cleanliness and controlling antibiotic prescribing are also part of the package to tackle C difficile.

&#149 Prof Hugh Pennington is a leading microbiologist, based in Aberdeen.