Warnings of Last Resort

"With incredibly severe cases, you can actually end up with perforation of the bowel. I think pediatricians are getting way more questions about C.diff. than they used to and I think there's more awareness of it among pediatricians and family doctors. They are ordering more testing and recognizing more cases, and then wonder how they're supposed to treat them."
Dr. Joan Robinson, chair, infectious diseases and immunization committee, Canadian Paediatric Society

Ordinary people, consumers of hygiene products, were delighted when soaps came on the market that boasted they were anti-bacterial. There was little doubt at first that the wider use of anti-bacterial cleansing agents like the ubiquitous liquid soap preparations used everywhere to combat the presence of germs and bacteria represented an advance against the microscopic vermin that threaten human health. They would advantage us in our never-ceasing battle against infections.

And then, over time, it became increasingly obvious to health researchers that the advent of a wide sweep of bacterial-resistant cleansing agents and other types of normally used disinfectants, along with the too-frequent use of those bacterial-battling antibiotics encouraged the growth of ever-expanding, ever-changing bacterial micro-organisms, altering their DNA to counteract the effects of antibiotics with ever-changing strains.

Until medical science finally realized that they had come to the end of their repertories of drugs to combat bacterial infections. The new strains of bacterium have become resistant to the most advanced presentations of antibiotic formulations, leaving the elderly, the very young and the immune-impaired to fight for their lives as all those prescriptive drugs formulated to defeat their ravages on the human body have increasingly failed.

Pediatricians in Canada, through the Canadian Paediatric Society, are being warned that the use of antibiotics in children is resulting in leaving those children at high risk for acquiring the C.difficile toxic gut infection that has become a dread adversary to human health within the medical community. Where such infections have traditionally been thought to target the vulnerable elderly, they are now affecting the vulnerable young.

The use of antibiotics for sinus infections, pneumonia, strep throat, ear infections, bronchitis, tooth infections, acne, diverticulitis, and sexually transmitted disease infections, along with all manner of other types of infections; including the proactive prescription of antibiotics for post-surgery recovery all represent an overuse and over-reliance on the use of antibiotics. Exacerbated by the fact that anxious patients insist that their doctors prescribe antibiotics in instances where they can be of no practical benefit.

Published in the journal Paediatrics & Child Health, the new position statement on C. difficile of the Canadian Paediatric Society appeals to doctors to curb their prescriptive use of antibiotics. They can destroy normal healthy gut bacteria, allowing deadly C. difficile spores to proliferate unhindered. The bacteria multiply hugely, causing swelling and irritation of the colon. And colitis which results is an inflammation causing diarrhea, fever and abdominal cramps.

Bowel contents can leak from the intestine into the abdominal cavity and this has the potential to trigger serious, potentially life-threatening infections. Those infections can cause kidney failure or septic shock. Conditions that can lead to irreversible morbidity in the elderly, though rarely severe and fatal infections in children. The spores of C. difficile are contained in feces; with inadequate hygiene, contaminated surfaces can infect others.

The potential to spread the infection between patients if hospital staff haven't cleaned their hands between attending to individual patients is very real. In a Canadian study, adults between 60 to 90 years of age infected with the hyper-virulent strain of C. difficile ended up twice as likely to die or develop severe disease, as opposed to people whose infections are not as dangerous.

"While outbreaks and severe disease have been reported mostly in adults, pediatric disease is also being reported", emphasizes the newly-published CPS position statement. One American study revealed that 26% of infections in children occurred in infants below one year of age, while 5% occurred in babies less than one month old.

In a Quebec-based study, 200 children treated for C. difficile-associated diarrhea found that the median age of the children was 2.6 years, the vast majority of whom had been exposed to antibiotics or had been hospitalized within the previous one to two months. The hospitals that people have always assumed to be the safest place for ill people to be, remain such, but the opportunistic bacteria that proliferate in an environment thriving with infections exposes them to those infections.

New experiments with re-seeding the human gut with the useful, healthy gut bacteria through the reintroduction of a slurry comprised in part of fecal matter, most often taken from family members to alleviate C.difficile-derived problems of ill health have been tentatively proven successful, and that may represent one more aid in the battle against severe bacterial infection.