Doctors See Gains Against ‘an Urgent Threat,’ C. Diff

June 25, 2018 by in category Infectious Disease with 0 and 0
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Doctors See Gains Against ‘an Urgent Threat,’ C. Diff

Tom and Wendy Bocci at their home in Troy, Mich. Mr. Bocci suffered recurrent C. diff infections that nearly killed him. CreditLaura McDermott for The New York Times

Tom Bocci’s encounter with a bacterium he had never heard of began in April, when his doctor suggested a test for prostate cancer. Because the results appeared slightly abnormal, Mr. Bocci underwent a biopsy, taking antibiotics beforehand as a standard precaution against infection.

There was no problem with his prostate, it turned out. But a few days later, Mr. Bocci developed severe diarrhea, fever and vomiting. He grew dehydrated. Five days afterward, in a hospital emergency room, doctors diagnosed a Clostridium difficile infection.

Antibiotics appeared to squelch the infection but, as happens in 20 to 30 percent of cases, the symptoms returned with a vengeance as soon as he finished the drugs. Over several months, Mr. Bocci suffered from migraines, weakness, anxiety and hypertension.

Told to isolate himself, he warned family members not to visit his home in Troy, Mich.; his wife, Wendy, moved into a spare bedroom. He lost 30 pounds. After the third recurrence, “I really thought I was going to die,” Mr. Bocci, now 71, said. “And sometimes I felt I wanted to.”

Though C. diff, as the bug is known, was identified in the 1930s, it became one of the country’s prime health concerns only a few years ago, after a particularly virulent and drug-resistant strain called NAP1 emerged in the 2000s.

By 2011, an analysis by the Centers for Disease Control and Prevention estimated there were 453,000 cases a year and 29,300 deaths from the infection. Two years later, the C.D.C. categorized C. diff as an “urgent threat.”

It remains one today. But now experts are sounding guardedly optimistic.

The agency is still analyzing surveillance statistics and will not issue a report until later this year. Still, said Dr. Alice Guh, a medical officer at the C.D.C.’s Division of Healthcare Quality Promotion, “We are moving in the right direction.”

In one region of upstate New York, for example, C. diff infections in nursing homes — a common occurrence — have dropped sharply to about 170 cases a year from about 450, said Dr. Ghinwa Dumyati, an infectious disease specialist at the University of Rochester who works with the C.D.C. “We’re trying to see if this is an isolated finding or is happening at other sites,” she said.

At the same time, a small army of researchers across the country is testing innovative treatments, and three pharmaceutical companies plan to roll out large-scale vaccine trials.

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