Warning over 33% surge in deadly diarrhoea bug as toxin spreads in NHS hospitals

Credit: Getty RATES of a potentially fatal stomach bug have surged by more than a third in hospitals in England since 2020, shock figures suggest. Clostridioides difficile – known as C. diff – is the leading cause of hospital-acquired diarrhoea and can be life-threatening for older patients. Its spores are highly resistant to heat and many disinfectants, making them easily transmissible in hospitals. But research suggests that roughly one in seven cases is deadly as it triggers peritonitis, a life-threatening infection of the abdomen’s inner lining. Sign up for the Health newsletter Thank you! Now, UK health officials, who assessed the health records of more than 51,000 Brits, have found that C. diff cases rose from 9,273 in 2019/20 to 11,752 cases in 2023/24. According to the UK Health Security Agency (UKHSA), “from 2020/21, the rates of C. diff infection began increasing annually with a 33 per cent increase in cases between 2020/21 and 2023/24 seen nationally.” Writing in the journal Eurosurveillance, they said that patients were predominantly older, aged 72 on average. They were also frailer, more likely to have kidney disease and to have recently had a course of antibiotics. It is believed C.diff infections may often come about when a patient takes antibiotics because it reduces the number of ‘good bacteria’ in their gut. This leaves them vulnerable to C.diff, which is otherwise out competed by so-called good bugs. Most read in Health “All antibiotics except amoxicillin increased the risk of C. diff infection significantly,” the researchers said. “Therefore, extra care must be taken to protect individuals who have had previous exposure to any of these antibiotics, aligning with current research emphasising the impact of antibiotics on the gut microbiome.” Patients with C. diff had also spent an average of 27 nights in hospital over the previous 12 months, compared to just four night among those who did not have the infection. Among the regions with the highest proportion of cases were the North West which was 17 per cent more likely and Yorkshire and Humber, which was 16 per cent more likely to have been diagnosed with C. diff. There is also a “considerable economic healthcare burden” associated with an infection, UKHSA scientists added. “An initial C. diff episode requires an average length of stay of 17 days, potentially extending to 33 days for recurrent infection.” One 2018 study also estimated that the cost per patient to the NHS ranged between £12,710 and £31,121. Earlier this year, a survey of more than 1,000 NHS staff also found that nearly 80 per cent of them did not know the hygiene steps they needed to take to protect patients from C. diff infections. As a result, one in five members of staff said that they did not routinely test for C. diff if a patient develops diarrhoea in hospital, according to the research by Tillotts Pharma UK. Writing in the journal, UKHSA researchers concluded: “Hospital staff should be aware of the explainable rise in cases and prepare for future years accordingly. “An ageing population and recent antibiotic use in primary care explain a smaller proportion of the rises we see.” But, they added: “There is a significant underestimation of the number of cases predicted, beginning in the Covid pandemic and continuing onwards. “We hope that further work can explore what might be underpinning this unexplained rise in cases, and that further data on hospital pressures and hospital antibiotic prescribing might soon be available to better understand the key drivers associated with the increase in C. diff infections.” What is C. diff? Clostridioides difficile – also known as C. diff – is a type of bacteria that can cause diarrhoea. It often affects people who have been taking antibiotics. C. diff bacteria usually live harmlessly in your bowel along with lots of other types of bacteria. But sometimes when you take antibiotics, the balance of bacteria in your bowel can change, causing an infection. When someone has a C. diff infection, it can spread to other people very easily if the bacteria found in the person’s poo get onto objects and surfaces. Symptoms of an infection: Diarrhoea High temperature Loss of appetite Feeling sick Stomach ache You are at higher risk if you: Are aged 65 or over You’re taking, or have recently taken, antibiotics You’re staying in hospital or a care home for a long time You have a weakened immune system – for example, from having a long-term condition like diabetes or kidney failure, or treatment like chemotherapy You’re taking a proton pump inhibitor (PPI), such as omeprazole, or other medicines that reduce stomach acid You’ve had a C. diff infection in the past Source: NHS Comment now