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Briefing Paper for the Health Committee on the practices in place in South Eastern Trust to address Clostridium difficile and the most up-to-date figures available (January – 15th February) on the number of cases of C difficile infection and the number of deaths where C difficile was recorded on the death certificate.

Background Information

Clostridium difficile presents in a wide range of symptoms, especially diarrhoea ranging from the mild to severe and those at most risk of contracting the condition are the elderly who have recently been on antibiotics and have some underlying illness or condition. The vast majority of patients recover very quickly. Clostridium Difficle is a recognised complication of antibiotic therapy in the frail elderly.

In 2007 the Trust admitted 43,000 patients. Within our Trust area we have one of the highest population growths in the 65+ age group in comparison with the rest of Northern Ireland. In addition to that the greatest rate of increase will be in the section of the population aged 85 years and over, which will see an increase of between 39% and 46% of the population (source NISRA) It is recognised that this particular age group i.e. over 65 years have increased susceptibility to C Difficile. A proportion of patients are admitted with symptoms which may subsequently be diagnosed as Clostridium difficile. The South Eastern Trust has a range of practices in place to reduce the spread of infection. The South Eastern Trust monitors each and every patient who presents with C.Difficile and they are appropriately managed within clearly defined and well established protocols

Practices in place to address Infection Prevention and Control

Cleanliness is a priority for the South Eastern Trust - in a very recent unannounced KMPG Audit as part of the Cleanliness Matters Strategy the South Eastern Trust scored very highly. The auditors scored the level of cleanliness at our hospitals higher than we scored ourselves.

An action plan is near completion to meet the infection reduction targets for April 2008/09.

The South Eastern Trust has in place a range of practical measures to prevent and minimise the risk of C.Difficile by

Management of a patient/clients care with suspected C Difficile

Number of cases of C Difficile infection 1st January 2008 to 15th February 2008.

The South Eastern Trust does not have an outbreak of Clostridium Difficle. The numbers presented are as accurate as possible however they have not been validated and consequently should be treated with caution.

During the period 1st January to 15th February 2008 the South Eastern Trust had 26 confirmed cases of Clostridium difficile of these 8 are deceased and of these there was 1 primary cause of death and 1 secondary cause of death.

It should be noted that the individual with the primary cause had two other primary causes noted on the death certificate, Clostridium difficile was listed as third in priority.

The South Eastern Trust must again emphasise the numbers presented in this paper are provisional and awaiting validation.