UPDATE 1-Diarrhea bacteria common in U.S. hospitals -survey

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By Maggie Fox, Health and Science Editor

WASHINGTON, Nov 11 (Reuters) - A common and sometimes deadly cause of diarrhea is far more common in U.S. hospitals than people thought, and only better hygiene and more judicious use of antibiotics will help, experts reported on Tuesday.

As many as 13 out of every 1,000 hospital patients are infected with Clostridium difficile, the Association for Professionals in Infection Control and Epidemiology reported.

This is as much as 20 times greater than previous, admittedly loose, estimates, the group said, and adds up to about 7,000 patients on any given day.

And as the U.S. population gets older and more frail, more patients are at risk of serious C. dificile that can kill them, said health-care epidemiologist Dr. William Jarvis, who led the study.

"You can get disease that ranges all the way from simple diarrhea all the way to perforation of the bowel requiring surgery, ... shock and death," Jarvis said in a telephone interview.

APIC's 12,000 members collected data about all of diagnosed C. dificile patients on one day between May and August 2008 at 648 hospitals. They covered 12.5 percent of all U.S. medical facilities including acute care, cancer, cardiac, children's and rehabilitation hospitals.

Jarvis said the sample was representative of the nation as a whole and showed a surprising number of people were infected.

"We are still trying to get a grip on it," he said. Because the bacteria are hard to grow in culture, usually doctors order a test that misses the infection 25 percent of the time, he said. And because C. dificile is not a reportable disease, few records are kept.

ONLY BLEACH

Antibiotics kill natural bacteria in the gut and allow invaders such as C. dificile to flourish, Jarvis added. And it makes spores that cannot be killed by non-bleach cleaners or alcohol-based hand rubs.

"Antibiotics don't kill it and most germicides used for environmental cleaning don't kill it. Only bleach does," he said.

And by the time patients are diagnosed, they have had a day or two to contaminate their rooms and everyone who has had contact with them, he said in the study to be published in the American Journal of Infection Control.

"Health care consumers need to be aware that most U.S. hospitals are not consistently following basic infection control practices against C difficile," Lisa McGiffert, director of Consumers Union's Stop Hospital Infections Campaign, said in a statement.

"Patients are already having to remind doctors to wash their hands, but they shouldn't have to bring bleach with them to make sure their rooms are clean."