Researchers determined antibiotic misuse — not poorly cleaned hospitals — was the primary driver in surging rates of Clostridium difficile across the U.K.'s publicly funded healthcare system, according to a new study published in The Lancet Infectious Diseases.
High rates of C. diff across U.K. hospitals first came to public attention in 2006, spurring new deep cleaning protocols and a reduction in antibiotic use. The new protocols resulted in an 80 percent drop in C. diff rates, though the main driver of this reduction was unclear. .
To determine the primary cause of the spike in C. diff cases and identify the specific protocols that subsequently reduced infection rates, researchers examined national data on the rates of C. diff from 2006 to 2014, antibiotic prescribing data from the same time period and genome sequences from 4,045 national and international C. diff isolates. The isolates were examined to determine the rate of C. diff infections resistant to antibiotics.
Analysis revealed limiting the number of prescriptions for antibiotics like fluoroquinolone was the primary cause of the significant drop in C. diff rates.
"These findings are of international importance because other regions such as North America, where fluoroquinolone prescribing remains unrestricted, still suffer from epidemic numbers of C. diff infections," said Dr. Derrick Crook, a study co-author and a microbiologist from Oxford University in the U.K.
C. diff was linked to nearly 500,000 infections in the United States in 2011, according to the CDC. Approximately 29,000 of those infected died within 30 days of diagnosis.
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