RESISTANT Clostridium difficile

[Jeffery Hammond]

This is not so new anymore. This virulent strain has been reported upon
numerous times over the past year. It seems to be worldwide (e.g. eastern
Canada, france, etc) but sporadic in appearance.  For example, while it has
appeared here in NJ, we have (fortunately) not been hit. 

Very quickly progressive with huge WBC counts. Mortality rates reported as
high as 30-35%.

Likely related to some degree to the use of waterless soaps. In solving one
problem (SSI) we may have created another.

Jeffrey Hammond MD, MPH
New Brunswick, NJ

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of KMATTOX at aol.com
Sent: Thursday, January 03, 2008 11:17 PM
To: ccm-l at ccm-l.com
Cc: trauma-list at trauma.org
Subject: RESISTANT Clostridium difficile

In Houston, particular in the suburbs, cases of SEVERE RESISTANT C.  
Difficile are being seen.    Resistant to both Flagyl and  Vancomycin.
WBCs as high 
as 80,000.   Often in  immunosuppressed patients, but not necessarily in HIV

infected  patients.   Seems that the patients are on PPI  drugs.     I am 
aware of the CDC reports and a few of the  recent case reports.    From ONE 
hospital in Houston (not mine) I  am aware of 6 cases.      A couple have
had 
operations  because even after 8 weeks they were still very sick and at
operation 
they had  thickened large bowel.     
 
I am reporting this for two reasons:
 
1.    Have you seen such severe resistance in  C.difficile?
2.    If this is a NEW phenomena, then we need to  spread the word.
 
k



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