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Fact file: What are C. difficile, MRSA and CRE?

Watch the video above: (Jan. 16) How hospital design can keep us healthier. Sean Mallen reports. 

What is C. difficile? 

C. difficile, or Clostridium difficile, is bacteria that grows in the bowel or digestive system and can cause diarrhea and serious intestinal conditions.

Who’s most at risk?
The disease generally affects vulnerable patients who have taken antibiotics and is typically spread in hospitals through contact with fecal matter.

C. difficile is widespread in the environment, with up to five per cent of the population carrying it without ill effect.

The bacteria produces spores that can contaminate surfaces and are difficult to eradicate with most cleaning products, making it one of the most common causes of infectious diarrhea in hospitals and long-term care homes.

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What are the symptoms?
The main symptoms of C. difficile are the following:
• Watery diarrhea
• Fever
• Abdominal pain
• Cramps
• Fast heartbeat
• Loss of appetite


How is C. difficile spread?

The disease spreads through contaminated stool and through dirty surfaces, including bedpans, door handles and toilets.

How can the disease be treated?
While most patients who contract the infection are cured with a course of antibiotics, between 20 per cent and 30 per cent of patients will suffer a recurrence. In severe cases, C. difficile can be fatal.

Patients who continue to suffer relapses of the debilitating and potentially deadly bowel infection can sometimes turn to a last-ditch salvage therapy known as a fecal transplant. Doctors transplant stool from a healthy donor into the intestinal tract of a patient whose colon is overrun with the C. difficile bacterium. The idea is to repopulate the colon with so-called good bacteria from the donor stool in a bid to crowd out the disease-causing agent.

For initial or mild episodes, doctors can prescribe metronidazole, also known as Flagel. For severe or recurrent infections, vancomycin in pill form is administered. Sometimes the two drugs are used in combination.

Earlier this month, a new antibiotic specifically developed to treat C. difficile infections was approved for the Canadian market. The drug, to be sold under the brand name Dificid, has been shown to cut the risk of recurrent bouts of diarrhea in some people suffering from C. difficile.

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Watch the video below: Why some experts think all hospital rooms should be private. Sean Mallen reports. 

How can I minimize my risk?
Follow these tips to prevent the spread of the bacteria:
• Wash your hands thoroughly with soap and water: If you work in a hospital or in a long-term care facility, or if you are visiting someone there, Health Canada advises that you should wash your hand often, especially after using the washroom or before and after handling food or medication. Most hospitals provide alcohol-based hand sanitizer at the entrance.
• To prevent an outbreak of the disease, dirty surfaces, rooms in hospital and nursing homes should be thoroughly cleaned between people.

What is MRSA?

Methicillin-resistant Staphylococcus aureus – or MRSA – is a bacterium that causes infections in different parts of the body. It’s gained its superbug status because it’s resistant to some commonly used antibiotics, according to WebMD. It’s been around for at least 20 years.

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Health Canada says that most MRSA infections and outbreaks occur in people in hospital or other health care facilities. Patients who already have weakened immune systems and chronic conditions are most susceptible to the infection.

MRSA is usually spread through direct physical contact or through contact with objects contaminated with infected bodily fluids. If you pick up the bacteria on your hands through an infected person or surface, you can spread it to others, Health Canada says. Open wounds on the body can also infect other people.

If MRSA is detected early, it can be treated with antibiotics other than methicillin.

Symptoms of MRSA

MRSA tends to appear as a skin infection, like a boil, but it depends on where you’ve been infected. The wound would look swollen, red, painful or pus filled. Many people who have a staph skin infection confuse it with a spider bite.

If it isn’t a wound, and MRSA infects your lungs, you could be dealing with pneumonia, shortness of breath, fever, cough and chills.

What is CRE?

Carbapenem-resistant Enterobacteriaceace – or CRE – are a family of germs that are difficult to treat because they’re resistant to most antibiotics, according to the Centers for Disease Control and Prevention.

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Certain species, like E.coli, are examples of Enterobacteriaceace, and they’re normal human gut bacteria but they can become resistant to medication.

NDM-1 – the New Delhi superbug – is also under the CRE grouping.

Healthy people usually don’t get CRE infections, the CDC says. In health care settings, CRE infections mostly occur in patients who are receiving treatment for other conditions. Who’s most at risk? Patients who rely on devices like ventilators, urinary catheters of intravenous catheters and patients who are taking long courses of antibiotics are most vulnerable.

The CDC says that research suggests CRE bacteria can contribute to death in half of patients who become infected with it.

Symptoms of CRE

With CRE, patients could be dealing with pneumonia, bloodstream infections, wounds or surgical site infections and meningitis. With CRE, infections can present themselves in different ways, depending on the patient.