Deaths from 'dirty hospital bug' double in five years

The hospital bug Clostridium difficile is causing more than twice as many deaths as it did five years ago, the first official figures show.

Inadequate infection control measures in hospitals and declining levels of cleanliness are believed to be behind the rise. Increased reporting of cases has also contributed.

The Healthcare Commission, the Government's NHS watchdog, warned last December that more than a third of NHS trusts had failed to implement government guidelines aimed at curbing infections of C.difficile.

Today the commission is to publish a survey of hospital patients that suggests standards of cleanliness have fallen.

The first report on deaths linked with C.Difficile published yesterday by the Office for National Statistics, show they rose from 975 in 1999 to 2,247 in 2004.

In more than half the cases (55 per cent) C.difficile was identified as the underlying cause of death. In the remainder, it was a "contributory factor".

That is more than twice the number of deaths linked to MRSA, the antibiotic resistant superbug. C.difficile is a bacterium that causes severe diarrhoea and mainly affects elderly patients. It forms spores that can lie dormant in hospital bed clothes and on furniture and are hard to remove by cleaning. An outbreak of a virulent strain of the bug, C.difficile 027, killed 12 patients and infected hundreds at Stoke Mandeville Hospital in Buckinghamshire. Further outbreaks were identified at the Royal Devon and Exeter Hospital and Oldchurch Hospital in Essex. The strain has since been identified at more than 40 hospitals around the country.

Patricia Hewitt, the Health Secretary, announced an inquiry into the Stoke Mandeville outbreak in June 2005 to be conducted by the Healthcare Commission. Yesterday the commission said the report had been delayed.

Murray Devine, the head of safety at the commission, said: "These figures are worrying. There is a lot more that trusts can do to minimise the risk to patients. Progress by trusts in reducing rates of hospital infection will be an important part of their rating in the new annual health check."

Today's survey - which examined in-patients' views of the treatment and care they received - was conducted last autumn. It found that more than 90 per cent rated their care as good or excellent and almost 80 per cent said they were treated with dignity and respect.

However, just more than half (52 per cent) said their ward was very clean, down from 56 per cent in 2002. Less than half (46 per cent) described the lavatories as very clean, compared with 51 per cent in 2002. The survey found wide variation among hospitals, with less than a third of patients in some saying their ward was very clean compared with nine out of 10 in others.

Patients also complained they were given too little information about their condition, the side effects of medication or the danger signs to look out for once they got home. Too little help was given to those needing assistance to eat.

A spokeswoman for the commission said: "The wide variation ... in patients' ratings is worrying. In some areas, trusts are performing very well. In others they are not."

Andy Burnham, the Health minister, said: "We have now released a high impact intervention for the NHS to help reduce C.difficile infections, and we are also legislating to put a hygiene code and a tougher inspection regime into law."

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