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The Headlines

Patients killed by new bug strain. A new and more virulent strain of a potentially fatal hospital infection is being seen in the NHS.

At one trust - Stoke Mandeville in Buckinghamshire - 12 patients have died and 300 have been infected since 2003. Clostridium difficile, which causes severe diarrhoea, mainly affects elderly people, although the new strain has also affected younger patients. Health experts said measures to stop the bug spreading amongst patients have been introduced.

The Facts

What is Clostridium difficile? - Clostridium difficile (so called because when it was first discovered it was difficult to grow in the laboratory) is a cause of diarrhoea, which is usually acquired in hospital. Although in most cases it causes a relatively mild illness, occasionally and particularly in elderly patients, it may result in serious illness and even death. The bacterium produces two toxins which are responsible for the diarrhoea and which damage the cells lining the bowel. However, not all strains of C. difficile produce toxin; these strains are unlikely to cause disease and patients colonised by them remain healthy. In addition, the bacterium can form spores which enable it to survive in the environment outside the body and which protect the organism against heat and chemical disinfectants

What does Clostridium difficile cause? - C. difficile infection is usually acquired in hospital, and almost all patients who develop C. difficile diarrhoea are taking, or have recently been given, antibiotic therapy. Diarrhoea is the most common symptom but abdominal pain and fever may also occur. In the majority of patients, the illness is mild and full recovery is usual, although elderly patients may become seriously ill with dehydration as a consequence of the diarrhoea. Occasionally patients may develop a severe form of the disease called 'pseudomembranous colitis' or 'antibiotic-associated colitis' which is characterised by significant damage to the large bowel. This may lead to a grossly dilated bowel possibly resulting in rupture or perforation. Unlike some other causes of diarrhoea, it is rare for C. difficile to spread to other parts of the body such as the blood stream.

What is the risk to health care workers, funeral Staff and patient's relatives? - Because most patients with this condition have recently received antibiotics, hospital staff, patient's relatives or funeral service staff are at little risk of catching the illness themselves. However, should these people be receiving antibiotics then they may be at some risk of infection, and therefore they should be especially scrupulous in their hand washing.

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