Figures released yesterday revealed there were 44,488 cases of Clostridium difficile (C difficile) among over-65s in England in 2004 – up from only about 1,000 cases a year in the early 1990s.
By 2000 the number had risen to more than 20,000 and b
y 2003 the number of cases had leapt again – to 35,536.
Pensioners are more susceptible to contracting the diarrhoea-causing infection, which affected almost 5,000 patients last year in Yorkshire alone.
According to the Office for National Statistics, in 2003 there were 1,748 mentions of C difficile on death certificates, of which 934 noted the infection as the underlying cause of death.
Karen Jennings, head of health at union Unison, said: "It's not rocket science – the way to wipe out these bugs is to have cleaner hospitals and if you want cleaner hospitals you must have more cleaners.
"Cleaners are the frontline of defence and yet contracting out has led to a drastic cut in the number of hospital cleaners."
Gordon Lishman, director general for Age Concern England, said the figures would worry many older people as they were the biggest users of the NHS.
"Many hospitals are clearly not doing enough to keep the wards safe and clean. Hospitals should be complying with new core standards on hygiene but we fear that some may be flouting these."
Liberal Democrat health spokesman Steve Webb said: "Ministers have been constantly playing catch up on the issue of hospital infections because successive governments refused to take the problem seriously. MRSA has grabbed the headlines but it is not the only bug on the rise in the NHS.
"These figures show the need for urgent action to reduce all hospital infections."
It is the first time that the Department of Health has published figures from its mandatory surveillance scheme for C difficile-associated diarrhoea.
Most infections occur in hospitals and nursing homes, but it can also be diagnosed in primary care.
A regional breakdown of the figures showed that the trust with the highest rate among over 65s was George Eliot Hospital NHS Trust in the West Midlands, which saw 342 cases in 2004.
That amounted to a rate of 4.05 cases per 1,000 bed days – a bed day is defined as one person in hospital for one night.
Yorkshire hospitals did not do too badly, the worst was Chesterfield Royal Hospital NHS Foundation Trust, which had 269 cases – amounting to 2.48 per 1000 bed days – followed by Hull & East Yorkshire Hospitals NHS Trust which had 592, or 2.28 cases per 1000 bed days.
Doncaster and Bassetlaw Hospitals NHS Foundation Trust and Scarborough and NE Yorkshire Healthcare NHS Foundation Trust had very few cases.
Doncaster had only 0.66 cases per 1,000 bed days and Scarborough just 0.70.
In June it emerged that more than 300 patients at Stoke Mandeville Hospital in Buckinghamshire had been infected with a virulent strain of C difficile since the end of 2003.
It was also revealed that 12 patients, whose average age was 85, died from the bug, which causes severe diarrhoea.
Despite this, Buckinghamshire Hospital NHS Trust featured quite far down the rankings, with 307 cases and a rate of 1.81.
Chief Nursing Officer Christine Beasley said C difficile diarrhoea occurred in patients who have received broad spectrum antibiotics – particularly the elderly and debilitated – but most patients made a full recovery.
"We have seen a rise in cases over the past decade, some of which is due to better reporting, but much of which is due to the increased number of patients with serious underlying illness who need antibiotics.
"We added C difficile and GRE to the mandatory surveillance system to help the NHS establish the scale of the problem, and provide information to help better infection control. We have issued guidance on dealing with outbreaks, with advice on antibiotic policies and isolating patients."
kateo'hara@ypn.co.uk
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