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Long-term plan needed for C. diff Long-term plan needed for C. diff
(about 8 hours later)
Scotland must invest "extraordinary resources" to clear hospitals of the deadly clostridium difficile (C. diff) infection, a leading expert has warned.Scotland must invest "extraordinary resources" to clear hospitals of the deadly clostridium difficile (C. diff) infection, a leading expert has warned.
Canadian Dr Mark Miller will tell a conference in Edinburgh later that ongoing vigilance is required. Canadian Dr Mark Miller has told a conference in Edinburgh that ongoing vigilance was required.
His warning comes a day after the first public session of the inquiry into the C. diff deaths at the Vale of Leven Hospital in Dunbartonshire.His warning comes a day after the first public session of the inquiry into the C. diff deaths at the Vale of Leven Hospital in Dunbartonshire.
Dr Miller will explain to delegates how C. diff has been tackled in Canada. The health secretary said all possible lessons would be learnt from outbreaks.
Health Secretary Nicola Sturgeon said Scotland had already put "extraordinary resources" into tackling C. diff.
In Scotland C. diff has overtaken MRSA as the leading cause of deaths from hospital-acquired infections, and it is rapidly becoming resistant to antibiotic treatment.In Scotland C. diff has overtaken MRSA as the leading cause of deaths from hospital-acquired infections, and it is rapidly becoming resistant to antibiotic treatment.
Resistant infections
Nicola Sturgeon, the minister responsible for health, called on doctors to be prudent in their prescribing of antibiotics as part of efforts to control the spread of infections which are resistant to the drugs.
Speaking at the event organised by the Royal College of Physicians of Edinburgh, Ms Sturgeon said: "Too many people believe antibiotics can cure all ills.
"And too many people expect to get one every time they visit their GP.
"We all must understand that only prudent prescribing can halt the rise in resistant infections and ensure that when we really need antibiotics that they remain effective."
C. diff rates and deaths are known to have risen, although it is hard to obtain an accurate picture of the trend.C. diff rates and deaths are known to have risen, although it is hard to obtain an accurate picture of the trend.
In the period 2000-2008 the General Register Office for Scotland reported an increase in the number of C. diff deaths from 116 to 765.In the period 2000-2008 the General Register Office for Scotland reported an increase in the number of C. diff deaths from 116 to 765.
Dr Mark Miller will tell Scottish doctors and microbiologists at the conference on Hospital Acquired Infection about the lessons learned from the Canadian experience. Dr Mark Miller told Scottish doctors and microbiologists at the conference on Hospital Acquired Infection about the lessons learned from the Canadian experience.
When the infection took hold there it was contained following stringent infection control procedures.When the infection took hold there it was contained following stringent infection control procedures.
The inquiry into the 18 C.diff deaths at the Vale of Leven is under wayThe inquiry into the 18 C.diff deaths at the Vale of Leven is under way
Dr Miller, who is from the Jewish General Hospital and McGill University in Montreal, said: "Extraordinary resources were required in each instance to control the epidemics and it is likely that similar interventions will be required in Scotland. Dr Miller, who is from the Jewish General Hospital and McGill University in Montreal, said: "Extraordinary resources were required in each instance to control the epidemics and it is likely that similar interventions will be required in Scotland."
He added that it was vital that healthcare teams did not view C. diff epidemics as requiring a one-off control strategy at the time of the outbreak. He added that it was vital healthcare teams did not view C. diff epidemics as requiring a one-off control strategy at the time of the outbreak.
"Any lapses in the increased level of infection control are usually followed by an increase in C. diff rates and related deaths." "Any lapses in the increased level of infection control are usually followed by an increase in C. diff rates and related deaths," he said.
Dr Ian Gould, form the Royal College of Physicians in Edinburgh, said: "Whilst the development of powerful antibiotic treatments has resulted in huge strides in surgical and medical treatment, antibiotic resistance to these same drugs threatens these advances and might even undermine conventional infection control measures.
But he added: "Scotland now has surveillance systems in place which will allow us to monitor antibiotic resistance and infection rates and to control both more effectively in the future."
The health secretary said an extensive range of new initiatives had been introduced.The health secretary said an extensive range of new initiatives had been introduced.
Ms Sturgeon said: "Encouragingly, we are now seeing significant and sustained reductions in the number of cases and we would expect the annual death rates to mirror this trend.Ms Sturgeon said: "Encouragingly, we are now seeing significant and sustained reductions in the number of cases and we would expect the annual death rates to mirror this trend.
"The Canadian cases date back to 2002/03 and we have already learned from these and other international cases in determining our Scottish strategy."The Canadian cases date back to 2002/03 and we have already learned from these and other international cases in determining our Scottish strategy.
On Monday the first public session of an inquiry into the C. diff deaths at the Vale of Leven Hospital in Dunbartonshire was held.On Monday the first public session of an inquiry into the C. diff deaths at the Vale of Leven Hospital in Dunbartonshire was held.
The hearing will also look into the handling of an outbreak at Ninewells Hospital in Dundee last year, in which five people died.The hearing will also look into the handling of an outbreak at Ninewells Hospital in Dundee last year, in which five people died.
Ms Sturgeon added: "We are determined to learn all possible lessons from every outbreak of C. diff and I look forward to seeing Lord MacLean's report following the Vale of Leven Inquiry."