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Third hospital is hit by new strain of superbug

Health Editor,Jeremy Laurance
Saturday 25 June 2005 00:00 BST
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A third hospital in Britain has been struck by the virulent new strain of the bug Clostridium difficile in a sign that the lethal infection may be spreading out of control.

A third hospital in Britain has been struck by the virulent new strain of the bug Clostridium difficile in a sign that the lethal infection may be spreading out of control.

Oldchurch Hospital in Romford, Essex, confirmed yesterday that 10 patients had contracted the infection and one had died. A spokeswoman for the Barking, Havering and Redbridge Trust said: "We have found this infection because we have gone looking for it. Our surgeons noticed when patients got C.difficile they were substantially iller than normal. We sent specimens for analysis and found they had the Type 027 strain."

The hospital is the third to be infected by the lethal Type 027 strain since The Independent revealed on 6 June that the bug had caused 12 deaths and infected 300 patients at Stoke Mandeville Hospital in Buckinghamshire, since 2003.

On Wednesday, the Royal Devon and Exeter NHS Foundation Trust said it had been stricken by the Type 027 strain where cases of C.difficile infection are running at twice normal levels.

There were 265 patients infected with C.difficile in the first five months of this year, compared with 254 patients for the entire previous year. Of 23 deaths since January, C.difficile was the underlying cause in 13 and a contributory cause in 10.

A committee of MPs yesterday castigated the NHS's handling of hospital infections. The issue was surrounded by a "fog of ignorance" and infection rates had soared, the Public Accounts Committee said. Jon Brazier, director of the Anaerobe Reference Unit at the University Hospital of Wales, the national referral centre for C.difficile, said little was known about the Type 027 strain until his unit started investigating at Stoke Mandeville hospital in the spring of 2004.

"It has since emerged as a real problem at Stoke [the infection rate surged again in 2005] and now we are finding it in other places," he said. "What is worrying is that consultants tell us when it does cause an outbreak it is a more severe disease. That fits with our laboratory studies, which show the new strain produces 10 times more toxin."

Patricia Hewitt, the Health Secretary, last week ordered an inquiry into the outbreak of C.difficile at Stoke Mandeville. The Healthcare Commission, the Government's NHS watchdog, said it would consider extending its inquiry after learning of the outbreak at the Royal Devon and Exeter hospital.

The Healthcare Commission's chief executive Anna Walker said: "We realise that these outbreaks are not easy to control. However, we really have to get to the bottom of why they are occurring."

Andrew Lansley, the shadow Health Secretary, said: "These outbreaks highlight that patients who should be protected from infection are not being protected because some of the basics are being got wrong."

The Type 027 strain is more virulent and harder to eradicate than ordinary strains of C.difficile but until this month had been rare. Only two isolated cases had been identified in Britain, in 1999 and 2002.

C.difficile mainly affects elderly patients and causes severe diarrhoea. One in five cases is resistant to antibiotics. The Type 027 strain is similar to one that has caused outbreaks in Quebec and the US.

Dr Brazier said: "We do not know how the organism is spread. We are asking doctors to keep a watch on cases of C.difficile and if they see an alarming change to contact us to investigate."

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