In 2008, antibiotic-resistant infections were increasing so much for patients in hospitals and other medical facilities that the U.S. government instituted a plan to eradicate these infections. Today, the plan is working—except for one particularly virulent bacteria called Clostridium difficile.

If you’re lucky, a C. difficile infection only causes explosive diarrhea, severe cramping, vomiting, fever and weakness. If you’re unlucky, it can kill you—the infection accounts for 14,000 deaths each year in the United States, according to the Centers for Disease Control and Prevention (CDC).  

C. difficile infections increased 400 percent between 2000 and 2007 and are continuing to rise today, according to the CDC. Almost all cases are acquired in a medical facility. Because studies show that C. difficile can live as long as two years outside a patient’s body, this sets up a chain in which patients in a hospital, nursing home, knee surgery center or any other type of healthcare setting who have the infection can actually pass it on to new patients long after they’ve checked out and gone home. 

Rub-a-dub-dub

But how does this actually happen? Surprisingly, according to data presented at the annual conference of the Association for Professionals in Infection Control and Epidemiology (APIC), one of the main factors behind C. difficile transmission is healthcare workers who don’t wash their hands. For every Grey’s Anatomy doctor who thoroughly lathers up before surgery, there’s a real-life one who doesn’t bother to cleanse his hands when he’s on patient rounds. And spritzing with hand sanitizer is useless, since research shows it won’t kill C. difficile bacteria.

Here’s how the infection process works: A patient with C. difficile releases germ spores from the skin that can collect on surfaces throughout his hospital room. A healthcare worker comes into the room to check on the patient and touches a bedrail covered with the spores. The worker then goes into another patient’s room without washing his or her hands first and touches the bedrail in the new patient’s room. The new patient is then exposed to the C. difficile germs from the patient next door. 

Even gloves may not prevent the spread of C. difficile, according to two studies discussed at the 2012 APIC conference. Researchers analyzed 202 intensive care unit healthcare workers’ hands and gloves and found that 1.5 percent had infectious bacteria on their hands under their gloves before going into a patient’s room, and 38.7 percent had it after leaving.

What’s more, because C. difficile germs live so long, patients who spend time in a room in a healthcare facility that hasn’t been properly cleaned can contract C. difficile from the previous patient. Research presented at the June 2012 APIC meeting showed that nearly one-third of the surfaces that are frequently touched in hospital rooms, such as light switches, phones and privacy curtains, aren’t cleaned thoroughly enough to kill C. difficile germs.

But despite copious data showing that handwashing helps stop the spread of infectious diseases like C. difficile, frequent lather-ups are such a hassle that many healthcare workers skip this vital step. In a presentation at the 2010 APIC conference, Atul Gawande, MD, said when he toured Brigham and Women’s Hospital in Boston with the infection prevention staff, he “realized the hardest part of their job is not keeping up with the science—instead, the hardest part is just getting people to wash their hands.”

Take charge of your health

A World Health Organization study presented at the 2012 APIC conference found that 57 percent of patients are unlikely to question their doctors on hand hygiene since they assume the doctors have washed their hands. “There is a perception out there by the public that surely this is already being done,” said healthcare consultant Leilani Kicklighter, RN.

However, that same study found that 71 percent of healthcare workers said infections like C. difficile could be reduced if patients simply asked if their doctor or nurse had washed their hands. 

Here are some other steps the CDC and APIC say you can take to reduce your chances of contracting C. difficile: 

• If you or a friend or family member live in a nursing home or other group facility, make sure the staff wipes down commonly touched surfaces that might be contaminated with C. difficile germs. The most effective cleansers are one part chlorine bleach to 10 parts water, and they need to remain on a surface for at least a minute. Other cleaning products don’t kill these hardy germs.
• Avoid antibiotics. C. difficile is part of the normal bacteria found in some people’s gastrointestinal tracts. It can live there for years without producing any symptoms because good bacteria in your system keep it under control. But antibiotics can not only kill this good bacteria, they can also cause the C. difficile in your body to start producing spores that spread the disease. If your doctor insists that you need an antibiotic to treat an illness, ask for one that is not broad-spectrum and that you can take for the shortest time possible. Ironically, antibiotics are used to treat C. difficile, but generally only two very powerful ones—metronidazole and vanomycin—are effective.