BUSPH and Partners Awarded $1 Million to Tackle Tough "C.diff" Infection

in Uncategorized
November 18th, 2009

A consortium led by the Boston University School of Public Health has been awarded a $1 million federal grant to test and evaluate interventions aimed at reducing the incidence of Clostridium difficile (or “C.diff”) infections, a stubborn bacterial strain that most commonly affects older adults in hospitals and long-term care facilities.

Mari-Lynn Drainoni

Mari-Lynn Drainoni

The U.S. Department of Health and Human Services recently awarded the grant to BUSPH and two partners – the Montefiore Medical Center in New York and the Greater New York Hospital Association – as part of a larger $17 million initiative to fight health care-associated infections. The Agency for Healthcare Research and Quality, in collaboration with the Centers for Disease Control and Prevention, has identified reducing C.diff as a priority.

C.diff infections, while rarely life threatening, can cause diarrhea and more serious conditions such as colitis and sepsis.

The consortium plans to assess current rates of C.diff at 10 New York–area hospitals, said Mari-Lynn Drainoni, associate professor of health policy and management at BUSPH, who is overseeing the project. Five of the hospitals will continue with the infection-control practices they already have in place, while the other five will implement new interventions.

Once the results are evaluated, the team hopes to develop a best-practices toolkit and manual to assist healthcare providers nationally in reducing C.diff rates.

“The reason I’m excited about this work is because it’s really practical and can make a difference in people’s lives,” said Drainoni, whose other research work focuses on HIV/AIDS and hepatitis.

C.diff-associated infections occur most often when antibiotic therapy suppresses the normal bacteria in a patient’s colon. Two out of three infected patients in U.S. hospitals in 2005 were elderly.

Interventions recommended to reduce C.diff in healthcare settings include adherence to strict hand-washing guidelines; use of contact precautions, such as gloves and gowns, as well as separating infected patients from the rest of the patient population; environmental equipment cleaning and decontamination; and “antimicrobial stewardship programs,” which restrict the use of antibiotics associated with C.diff and curb unnecessary antibiotic use.

Because C.diff can be caused by over-prescribing of antibiotics, “we plan to look at changing prescribing patterns,” Drainoni said. Other interventions could include strict environmental precautions

Montefiore Medical Center has physicians who are experts on C.diff infections, Drainoni said, while the Greater New York Hospital Association has taken steps in recent years to ramp up its fight against the infections, including prevention training for staff and early identification of the condition among patients.

Drainoni said she expects the study will take about two years to complete. BUSPH will be responsible for overseeing and evaluating the project.

Submitted by Lisa Chedekel