A Simple Solution to Hospital Infection

Holy Redeemer hospital in Montgomery County, Pennsylvania has access to complex equipment and expensive drugs, yet they have turned to a cheap solution for one of modern medicine’s most demanding problems.

A Simple Solution to Hospital Infection
Image Courtesy: fairview.org

Yogurt — the kind you buy at the grocery store — to fight Clostridium Difficile, a hospital-acquired infection that has been growing throughout the country.

After dietitians began encouraging patients taking antibiotics to eat yogurt, the infection rate fell by two-thirds. Holy Redeemer has now expanded the program to its nursing-home residents.

Jeanie Ryan a registered dietitian (who helped coordinate the effort) said “We were really surprised by how easy it was and how quick it worked.”

The Hospital & Health system Association of Pennsylvania earlier this year gave Holy Redeemer an Innovation Award for the program. Yet other hospitals still remain skeptical.

Thomas Jefferson University Hospital uses probiotics, or beneficial yeast and bacteria, in pill form only in clinically stable patients who must take antibiotics for long periods.

Neil Fishman, associate chief medical officer at the University of Pennsylvania Health System, said there was not enough science to support the wide use of yogurt or probiotics, and  can be dangerous in patients with compromised immune systems. He said the bacteria in yogurt were not native to the human digestive system and thus would not perform like the normal flora devastated by antibiotics.

Fishman wondered whether other measures helped reduce infection rates at Holy Redeemer. Fishman advises the Centers for Disease Control & Prevention on infection control. He said, “I love yogurt, but I doubt strongly that a two-thirds reduction is just due to eating yogurt. The most effective way to reduce C. diff, is to prescribe antibiotics more carefully."

Barbara L’Amoreaux, a Holy Redeemer spokeswoman, said there were no other changes in patient care in the year before the hospital asked patients to eat yogurt.

In 2011, Holy Redeemer officials became surprised by the rising numbers of hospital-acquired C. difficile cases. The bacteria cause severe diarrhea & can be serious.

In 2011, Holy Redeemer had 75 hospital-acquired cases.The bug is particularly hard to kill on surfaces, and despite isolation of infected patients, education of the staff, and a change in disinfectants, the infection rate did not improve.

The CDC says hospital cases nationwide have tripled in the past decade to nearly 337,000. Most C. difficile cases are related to medical care, but only about a quarter show symptoms first in the hospital, the CDC says. C. diff infections cost at least $1 billion a year in extra health-care costs.

While antibiotics are essential for fighting infections, they also can throw off the delicate balance of bacteria in our bodies by weakening both good & bad microorganisms. Without the good bugs to keep it at bay, C. difficile can make us sick.

At an infection-control committee meeting at Holy Redeemer, a surgeon suggested using probiotics against the bug. Jeanie Ryan & fellow dietitian Anne Kathryn Bromm knew that some hospitals were giving probiotics in granular form but liked the idea of giving a food- like yogurt to their patients. It is popular, and has the extra benefit of providing vitamins, protein and energy. 

After comparing many brands, they decided there was no good reason to pick one over another, and continued with the one they were already using — Dannon (contained three types of beneficial bacteria: S. thermophilius, L. bulgaricus, and L. acidophilus.) 

Interesting Facts;

In 2011, Holy Redeemer had 75 hospital acquired cases of C. Difficile.

In 2012, there were only 23 cases at Holy Redeemer after the hospital began encouraging patients to eat yogurt. 

In 2012, there were 55,968 cups of yogurt ordered by the hospital

There is a $1 billion dollar financial burden of treating C. Difficile infections each year.

There are 337,000 cases of C. Difficile each year at U.S. hospitals, a threefold increase over the last decade.

Most cases of C. difficile colitis occur in patients in the hospital, but the number of cases that occur among individuals not in the hospital has increased greatly.

Clostridium difficile colitis is an infection of the colon by the bacterium, Clostridium difficile ( C. difficile ).

C. difficile causes colitis by producing toxins that damage the lining of the colon.

The symptoms of C. difficile colitis are fever, diarrhea, and abdominal pain.

Serious complications of C. difficile colitis include dehydration, rupture of the colon, and spread of infection to the abdominal cavity or body. Severe infection is life-threatening.

The most common cause of C. difficle colitis is treatment with antibiotics. The antibiotics are believed to suppress normal colonic bacteria that usually keep C. difficile from multiplying and causing colitis.

The primary means of diagnosing C.difficile colitis is by testing for the bacterial toxins in samples of stool.

Centers for Disease Control and Prevention
Holy Redeemer