ECDC calls for review of infection control measures for C. difficile
Existing guidelines for control of Clostridium difficile (C. difficile) should be reviewed following recent epidemics in several European countries linked to a new hyper-virulent strain, says the European Centre for Disease Prevention and Control (ECDC).
A group of leading European scientists analysed existing protocols on behalf of ECDC with a view to limit the spread of C. difficile and has called for a combination of rigorous infection control measures with appropriate use of antibiotics.
The emergence and spread of hyper-virulent new strains of C. difficile, such as PCR ribotype 027, have contributed to multiple outbreaks in hospitals and care homes in Europe. These outbreaks have been characterised by patients developing severe diarrhoea, sometimes leading to severe inflammation of the bowel and death.
As of June 2008, C. difficile PCR ribotype 027 had been reported by healthcare facilities in 16 European countries. Outbreaks were reported in 9 countries including Belgium, Germany, Finland, France, Ireland, Luxembourg, The Netherlands, Switzerland and the UK (England, Wales and Northern Ireland). It was also detected in Austria, Denmark, Hungary, Norway, Poland, Spain and Sweden, and in Scotland.
Zsuzsanna Jakab, ECDC’s director said: “ECDC has recognised this emerging new disease and undertaken several actions to inform all EU Member States. ECDC is currently financing a pan-European surveillance study to estimate the incidence of hospital and community acquired C. difficile. The results will be available in 2009. We are also providing input to the European Commission, who are developing a policy proposal on patient safety in Europe”.
The report recommends that all EU Member States should be aware of C. difficile in healthcare facilities, and pay particular attention to the PCR ribotype 027. Evidence-based guidelines to prevent the spread of C. difficile should combine early diagnosis, surveillance, education of staff, appropriate isolation precautions, hand hygiene, use of protective clothing, environmental cleaning and cleaning of medical equipment, good antibiotic stewardship, and specific measures during outbreaks.