C. difficile infection puts Scots at greater risk of death

C. difficile infection is putting greater pressure on the NHS and hospital beds. Picture: Peter Byrne/PA Wire
C. difficile infection is putting greater pressure on the NHS and hospital beds. Picture: Peter Byrne/PA Wire
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The extra impact from 
C. difficile infection is putting patients at higher risk of death, leading to thousands of ­hospital beds being occupied and costing the NHS in Scotland more than £8.5 million a year.

Prof Alistair Leanord from the University of Glasgow, will tell the 27th European Congress of Clinical Microbiology and Infectious Diseases in Vienna tomorrow that 
C. difficile, which causes stomach upsets and diarrhoea, is linked to higher death rates in Scotland.

He will say the infection amounts to an extra 10,600 hospital bed days a year, “equivalent to a 30-bed hospital ward being fully occupied all year”. Prof Leanord, one of the world’s leading experts on infectious diseases, is set to reveal that the average cost of treating a patient with C. difficile infection was £7,500 compared with £2,800 for patients with other conditions.

In Scotland from October 2015 to October 2016, there were 1,150 cases of C. difficile infection in patients aged 15 and over. This cost the NHS in Scotland a total of £8.65m. The additional costs of treating C. difficile infection, over and above the basic cost of a hospital bed and normal medical care, was £1.9m.

The calculations were carried out at Strathclyde University, which is part of the Scottish Healthcare Associated Infection Prevention Institute research consortium.

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Until now, little has been known about the impact on health service resources from C. difficile infections, and on patients in terms of recurrence of infection, readmission to hospital, length of stay and death rates.

The researchers identified 3,304 patients with C. difficile in Scottish hospitals between 2010 and 2013 and matched them with 9,516 patients who did not have the infection (the control group). About two-thirds of the C. difficile patients acquired the infection in hospital.

Patients with C. difficile infection had more than double the risk of dying from any cause within two months of being admitted to hospital and nearly a third (29 per cent) died within two months against 14 per cent in the control group. Patients with C. difficile stayed in hospital an average 9.7 days longer than patients without the infection.

Of the 1,712 C. difficile patients discharged from hospital within 30 days of the first episode of infection, 59 per cent were readmitted within six months; of the 626 cases discharged more than 30 days after the first episode 53 per cent were readmitted within six months.

Few of these readmissions were directly related to C. difficile infection. “However, nearly a sixth of patients who were cured of the initial infection recurred within three months, and nearly one third of them had a second recurrence within a year,” Prof Leanord said.

Older people were more vulnerable to a recurrence. Among the patients with C. difficile infection, 22 per cent were aged 85 or over, and patients aged 75 and over had double the risk of a recurrence of the infection compared to those aged under 65.

Prof Leanord will conclude: “Having an understanding of C. difficile infections will allow the Scottish Government to target resources at the most appropriate patients to reduce the burden of the disease.”

Health Secretary Shona Robison said: “Scotland’s work on infection reduction is globally recognised. We have seen unprecedented reductions of around 90 per cent in the most common healthcare associated infections and have invested more than £10m to support key projects.

“Figures published by Health Protection Scotland show C. difficile infections in people aged 65 and over and MRSA have reduced by 87 per cent and 94 per cent respectively since national monitoring began in 2007.”

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