Scientists in the United Kingdom have isolated a new strain of *Clostridium difficile* (sometimes called c. diff.) that produces a highly toxic form of diarrhea that does not respond to commonly used antibiotics such as Cipro (ciprofloxacin).
The strain, NAP1/027, was first seen in an outbreak in hospitals in Quebec, Canada, but has also been associated with diarrheal disease in hospitals as widely spread as the United States, Britain, and the Netherlands. Researchers also obtained bacteria from the new strain in diarrhea in Quebec that was community, not hospital, acquired.
Clostridium difficile is a risk for patients recovering from colorectal surgery and those receiving chemotherapy. It can also result from changes in the healthy intestinal bacterial flora after the use of antibiotics.
The strain produces as much as 16-23 times the dangerous toxins as older c. diff. infection and can be fatal.. In 2003 and the first half of 2004, over 100 people died from the disease in the University of Sherbrooke Hospital near Montreal.
The research team examined bacteria from 124 patients involved in the Quebec epidemic and found that 67% of the hospital-acquired infections were due to the new strain — NAP1/027. However, there was also a 37% NAP1/027 infection rate among those who became sick in the community.
Michael Warny, M.D. and his team reported their findings in the September 24, 2005 issue of *The Lancet.* They offered this interpretation:
The severity of C difficile-associated disease caused by NAP1/027 could result from hyperproduction of toxins A and B. Dissemination of this strain in North America and Europe could lead to important changes in the epidemiology of C difficile-associated disease.
A
[Read an article about the NAP1/027 strain on *Medpage Today*](http://www.medpagetoday.com/PublicHealthPolicy/PublicHealth/tb1/1788)
[Read the study abstract in *The Lancet.*](http://www.thelancet.com/journals/lancet/article/PIIS014067360567420X/abstract)
January 03, 2006 at 12:20 am, Lynn said:
My mother acquired a C diff infection in early 2005. She had a colonoscopy in early March 2005, diagnosed as microscopic colitis and the physician said her colon was pink, clean, healthy, etc. Three weeks later she was readmitted to the hospital and continued to worsen with a white count of 35,000, had a total colectomy. I work in the pathology department of the same hospital and viewed her colon. It was completely destroyed with the yellowish plaques. She now has a permanent ileostomy. She is 81 and now lives with me. She has no quality of life, and continues to decline. She has since developed a large hernia around the stoma and all barriers fail, sometimes within a day of a new application. Needless to say, her and my lives have become hell. I have hired a full time home health care provider while I work, but when I come home my mother becomes my responsibility. This infection has destroyed both of our lives. If I could prove it I would sue the hospital where I work. She was C diff negative on repeated stool cultures during her first hospitalization for CHF, placed on Flagyl (her only antibiotic in probably 10 years). When she was readmitted for a TIA she was prepped for a colonoscopy and I believe she acquired her C diff infection at the hospital. She almost died and was on a vent for a week after her colectomy. I begged them to do anything to save her regardless of her DNR and living will. She survived only to contract a staph infection in her central line. Her surgeon said she was one of three elderly patients at the same time to require surgery. One man also in ICU died from his infection while my mother survived, if you want to call it surviving. She now “exists”, looks at her ilestomy appliance and says she would rather die than “live” with this. This is a terrible way to go.
December 10, 2006 at 9:34 pm, gina said:
I need information about antibiotic use for a patient with a sinus infection, whom has recovered from 2 relapses of c-diff. What are her antibiotic options for sinus infection?
December 11, 2006 at 2:37 am, Kate Murphy said:
C3: Colorectal Cancer Coalition cannot provide medical advice in specific situations. We don’t have general information about treating sinus infection, We suggest that you talk to a doctor, making sure that he or she knows about the previous history of c. difficile and the antibiotics used to treat it.