The danger has a name: «Ribotype 027»
New scientific findings on Clostridium difficile associated diarrhoea
Clostridium difficile is an anaerobic rod-shaped bacillus with a high environmental-resistance [1] and has been known as a pathogen causing Clostridium difficile associated diarrhoea (CDAD) for over 30 years.
It is fifth on the list of the most frequent hospital infections and has been classified up to now as relatively harmless. Clostridium difficile normally resides without any symptoms in the healthy gut [2] in an inactive spore form and in rather low numbers.
However if the natural gut flora is to a great extent eradicated, for example, by the use of broadband antibiotics then the bacteria Clostridium difficile can multiply due to its particularly resistant properties and the lack of competition. Through fast mutation Clostridium difficile thereby forms various strains.
The accelerated growth of the originally harmless state is associated with an overproduction of toxins. These cell toxins can vary greatly depending on their strain, type and amount. How potentially infectious a strain is depends on the amount of pathogenic-acting toxins released. There was an outbreak recently in Germany with particularly grave consequences.
The strain “Ribotype 027” which was responsible for this produced around 20 times more cell toxins than other strains. These toxins attacked the cells in the wall of the bowel and were therefore able to trigger various types of diarrheic illnesses and bowel infections with grave consequences.
Particularly at risk are those people with weakened immune systems, patients older than 65 years and/or those who have had to undergo immune suppression, chemotherapy or antibiotic therapy as well as those being tube-fed.
Due to the more intensive care required and the costs involved with the associated longer hospitalisation CDAD is responsible for an increase in costs in the health system:
- an estimated additional cost per CDAD patient is several thousand Euro;
- in Europe the costs add up to around 3 billion Euro,
- in the USA it is around 1.1 billion dollars per year.
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