An intestinal pathogen can wreak havoc within hospitals and medical facilities, putting patients at considerable risk of infection and its accordant complications. Avoiding an outbreak is paramount at our three endoscopy centers at Gastrointestinal Associates.
A recent study presented in Denver at the 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) noted that the rates of Clostridium difficile infection (CDI) nearly doubled in a decade in U.S. hospitals. The research by Kelly Daniels, PharmD, a graduate student at the University of Texas at Austin, examined 2.2 million people affected by CDI over 10 years.
Clostridium difficile, also known as C. difficile or C. diff, is a persistent pathogen – a gastrointestinal organism that is passed by carriers – and it has caused infectious outbreaks within healthcare facilities. Those afflicted suffer medical issues ranging from severe diarrhea to life-threatening inflammation of the colon.
We have never had an incident of Clostridium difficile at our centers at Gastrointestinal Associates. The keys to never exposing our patients to this pathogen are twofold: protocols and staff.
Hand-washing by medical staff members remains the most effective means of stopping the spread of illness within medical facilities. C. diff is believed to be most commonly transferred via human hands, so thorough and frequent hand-washing tops the list for prevention.
Facility protocols also serve a major role in safety. This involves proper sterilization, use and storage of medical equipment from thermometers to tubes.
The details of the recent study on C. diff and its increased prevalence and severity over the past 10 years point to antibiotics as a culprit. Deaths from the infection have leveled off – an indication that treatment methods have improved – but stopping the pathogen from getting a foothold in the first place remains the primary goal.
That goal is the particular focus for our endoscopy centers. Staff education is a critical component of infection control, as we are on the frontlines every day with patients and members of the public. They trust us to deliver expert care while keeping them unexposed to pathogens such as C. diff.
The question becomes: Why does a hospital have such infections while an Ambulatory Surgery Center (ASC) such as The Endoscopy Center(s), does not?
It is likely not an issue of cleanliness. Hospitals and ASCs both place a high priority on maintaining a safe environment with hand-washing always emphasized.
But consider this fact: Over the 27 years that we have provided endoscopic services, we have never had a transmission of a bacterial infection, hepatitis or HIV. The reason is that we follow only the highest standards of facility and instrument cleaning. Indeed, our centers have received the safety award from the American Society of Gastrointestinal Endoscopy.
There are three other significant differences between hospitals and ASCs.
Hospitals have patients with multiple, chronic and complex conditions that reduce the strength of a patient’s immune system, providing an opportunity for the growth of opportunistic, sometimes deadly germs. In contrast, ASCs typically treat healthier patients with healthy immune systems.
Furthermore, hospitalized patients are there for a number of days, allowing for growth of abnormal bacteria in patients with depleted immune systems. ASCs treat patients over a short time period, and do not provide opportunistic bacteria a chance to grow.
Lastly, our endoscopy centers are highly specialized in endoscopic procedures. We place a very high priority on safety, including prevention of infection. Our staff is specifically trained in maintaining a safe and clean environment for the endoscopic procedures we perform. Our endoscopic staff members are specialists in a very focused area, including cleanliness and safety in endoscopic facilities.
C. diff infections affect more than a half-million people each year, so it is a serious concern in healthcare facilities. And while older patients are the most likely to get infected, young patients also are at risk at a time when C. diff infections have become more severe than in the past.
The bacteria are found in feces, soil, water, air and foods. They are passed in feces and when carriers don’t thoroughly wash their hands, the bacteria can spread to surfaces, thus causing contamination to non-carriers. The bacteria spores can survive weeks, even months, thus our approach is to never let it get started.