Antibiotics helping breed deadly stomach bacteria in San Francisco hospitals 

At least two San Francisco hospitals have experienced recent large outbreaks of a virulent and sometimes-fatal species of bacteria, and experts say occurrences of the drug-resistant disease are likely to increase.

San Francisco General Hospital and California Pacific Medical Center on California Street both recently had outbreaks of Clostridium difficile, commonly known as C. diff. The bacterium, which has become common in hospitals the past two decades, takes up residence in the intestines of patients who have been treated with antibiotics for other infections. The bug causes acute diarrhea, but it can be treated once it’s identified.

Two weeks ago, about 10 patients at CPMC came down with the infection. Since the infections were isolated on two floors that treated postoperative patients, the hospital chose to relocate the patients and scour their rooms with bleach. All 10 patients recovered, according to CPMC spokesman Kevin McCormick.

San Francisco General also has had “an alarming increase in infections with C. difficile and multidrug-resistant organisms,” Dr. Lisa Winston, chair of infection control, told hospital leaders in May.

Details of the hospital’s outbreak were not forthcoming this week, and Winston was unavailable for comment. But according to the minutes of a May meeting of the Joint Conference Committee for San Francisco General Hospital, Winston said the facility has been working to control the number of cases. Doctors, nurses and visitors have been asked to carefully observe measures to avoid spreading the disease — measures typically as simple as wearing gloves when visiting patients.
Also, she said, the hospital might impose stricter guidelines about avoiding the prescription of antibiotics unless a patient is clearly in need of them.
The problem with antibiotics is they kill almost all bacteria in a person’s gut, except for drug-resistant C. diff. After all the other bacteria are killed, C. diff has plenty of room to infect and expand, and soon grows into a major and messy problem, said Dr. Sean Townsend, vice president of quality and safety at CPMC.

But the disease is far from abnormal, California Department of Public Health spokesman Ralph Montano said.

According to a report by the department, the disease might be the most common hospital-onset infection, and costs associated with it have been estimated at $3.2 billion a year in the U.S.

“C. diff happens at hospitals all over the state; it happens all the time,” Montano said.

Townsend said a more virulent and fatal strain of the disease has been slowly spreading, and it’s that strain that has hospitals even more worried about the spread of the disease.

Montano could not confirm whether any San Francisco hospitals have so far seen that strain.



Spreading bacteria

793: Fatal cases of C. diff in the U.S. in 1999
7,285: Fatal cases of C. diff in the U.S. in 2009
92: Percentage of fatal cases that occurred in people 65 and older

Source: National Vital Statistics Report

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