Despite my best handwashing efforts, gowning and gloving, I got cdiff. Three months ago. I just relapsed.
It has been a complete nightmare. I can't return to work. I can't eat. I'm in pain, I have fatigue, etc.
Now I have three more months to completely get better or I will be terminated. The hospital says that I can't prove that I contracted the c.diff there....and I'm harassed by HR to 'prove' that I'm still sick. Do they HONESTLY want me to PROVE that I have c.diff? Don't they think that I could find other things to fake other than this horrible disgusting illness?
My question is, have any ID nurses noticed an increase in your workers contracting c.diff, or a general increase in c.diff in your patients. About the time I got sick, I was on antibiotics, a very bad one in terms of c.diff. But others in my hospital have contracted it (RNs, CNAs and the like), and its seems that half of our ICU unit has it at sometime or another. Any advice would be helpful. Also, I wasn't even offered workman's comp, and I'm financially drowning....
:caduceus: Just attended inservice on c. dif yesterday presented my director of infectious diseases at geisinger medical center, pennsylvania. the # of cases of c. dif among hospitalized patients has doubled nationally since 2000. the c. dif of today is different from the c. dif before 1999. it's genetic make-up has changed. it is much more virulent causing a significant number of deaths among patients; also requiring colectomies in some. it is believed that flouroquinolones are responsible for this genetic change, particular tequin and cipro. the usual treatment of flagyl does not work. the first line drug is vancomycin (it always was but was considered too expensive). "full" dosing for one month, at least -- and then possibly 125mg po QOD. there is no set protocol at this time -- though some hospitals have developed their own. (Johns Hopkins, e.g.) some physicians are "winging it". also, it depends upon the testing method used as to the accuracy of testing for c.dif. the most common method is only 80% accurate. so, recommended if negative, obtain a second, then a third if necessary.
this new strain of c. dif is epidemic affecting at least 50% of elderly hospitalized patients on multiple antibiotics. it is affecting 80% of our patients. relapses occur in at least 30% of those who have it. first seen in new england and quebec. hope this is helpful -- and not too late for you.
To the original poster, you've gotten some great advice already. Just want to say I hope things work out for you.
A quick note about those foam hand cleaner dispensers. They are ineffective against c-diff. You must wash your hands the old fashioned way when dealing with it.
I also just attended an inservice on c. diff and quite truthfully it shook me a bit. My first thought was the big push we have all done on hand hygiene/alcohol hand sanitizer. Did we inadvertently spread the spores? I was very proud of myself for using that gel and praised all employees that I saw using it properly. Any thoughts or am I over thinking in my very tired state?
you are right. that was another important point made by the infectious disease specialist. the increase in c. dif over the past few years may be linked to use of alcohol-based hand gels/foam -- which is ineffective against spores (e.g., c. dif) -- he stressed the need for good handwashing using soap and water when dealing with c. dif.
I'm a microbiologist starting my second career as a nurse. "Hand sanitizers" make me cringe for so many reasons:
-50-70% Alcohol is NOT that effective against a LOT of things. It evaporates too fast to kill a lot of things you want gone. This is a first year biology lab experiment.
-Alcohol dries out your skin, making small cracks that just give infections a new way in
-Wash your darn hands already! Its still the most effective way to protect yourself and everyone around you! Stop trying to KILL the germs and get RID of them down the sink!
I certainly hope your C. Diff. gets better, and that this thread reminds everyone to be careful!
I'm a microbiologist starting my second career as a nurse. "Hand sanitizers" make me cringe for so many reasons:
-50-70% Alcohol is NOT that effective against a LOT of things. It evaporates too fast to kill a lot of things you want gone. This is a first year biology lab experiment.
-Alcohol dries out your skin, making small cracks that just give infections a new way in
-Wash your darn hands already! Its still the most effective way to protect yourself and everyone around you! Stop trying to KILL the germs and get RID of them down the sink!
I certainly hope your C. Diff. gets better, and that this thread reminds everyone to be careful!
I'm curious if you have any studies to support your post as it contradicts current research and CDC recommendations.
The guidelines that I am aware of recommend alcohol based products as an *adjuct* to regular good handwashing, when you can't wash, not a virtual replacement, which is how I see some (a lot of) people use them.
I think that compliance with the sanitizers probably is higher, and is therefore worth keeping it around, since, its better than nothing. But I am concerned that lots of people don't wash thier hands as often as they should and don't use these alcohol products properly or wash thier hands properly when they do take the time.
God, I better not ever be hospitalized. "You're gonna check me over? Did you wash your hands? No, that wasn't long enough, do it again. Let me see your nails?" I'd be a holy terror.
Maybe we should start hiring bathroom snitches to make sure everyone washes... :wink2: I'm only half kidding!
If you can find it, blueberry leaf tea is very astringent, and an old herbal remedy for diarrhea. There new probiotic formulas out that are enteric coated, and do not need refrigeration. Because of our stomach acids, some probiotics do not reach the intestines intact, hence the new enterics.
my heart goes out to you. i've never had c-diff, but i do have ulcerative colitis. so, when it's flared up, i get to experience the 15 - 20 bm's a day that are just water. once i'm flared, i stick to plain chicken breast and rice (in very small amounts)....no seasonings or flavorings of any kind. i drink huge amounts of water and sports drinks....when i'm real bad, i try to drink at least 24 ounces for each movement....my goal of course is to avoid hospitalization for dehydration, so far it's worked. i do also take the probiotic culturelle that some have mentioned....since at this point i'm not eating any yogurt. also, if tolerated....i try to drink an ensure a day (i like the chocolate and butter pecan flavors). i've lost over 25 lbs in 3 weeks during flares...so i try to supplement.
once i'm out of crisis mode.....i eat yogurt every day....not the bargain brands either, i eat a brand called nancy's..it's a local oregon brand, so i'm not sure how far it's distributed. but it's loaded with 4-5 kinds of active cultures. basically just look for one that's heavy on the active cultures.....also the more local the dairy is, the better since it's likely that more of the cultures are still alive. i also stay on a low residue diet for a couple of months (no whole grains, no nuts, no skins, no seeds...nothing that could be scratchy, for lack of a better word). basically, just baby your colon.
now i know that this stuff won't really help the infection (although bolstering the good bacteria, might do some good).....but it might make life a bit easier. the fatigue of that much diarrhea can be overwhelming, i remember wondering how i was going to drag myself out of bed for my next trip to the bathroom. hang in there and whine at us when you need to.
you are right. that was another important point made by the infectious disease specialist. the increase in c. dif over the past few years may be linked to use of alcohol-based hand gels/foam -- which is ineffective against spores (e.g., c. dif) -- he stressed the need for good handwashing using soap and water when dealing with c. dif.
For this reason, when a patient has C-Diff, we take out the alcohol-based hand gels/foam out of the patient's room, and emphasize the use of proper hand washing, gloves, gown. You'd be surprised how many doctors and nurses actually complain when there is no foam in the room. This is scary!
I've just read an article in either the Post Gazette or the Trib about the spread of Cdiff in the local hospitals. I think it was last week?
I've done a little research on Cdif for a resident that was plagued with it. There are some online and I think in person support groups. You are not alone. I work in LTC, so I've seen my share. It is a debilitating illness, esp when you are elderly, too. We have pts on Flagyl for at least 21 days, some longer. Vanco too. Also we are using Lactinex, yogart and Florastor. I've heard that macaroons (cookies) help ease the diarrhea? Do a search on this site.....I think we had info on this. Have you heard of a stool transplant?
We were just talking about this at work....Should this be a workers comp issue? Heck you got it at work.
Sorry to have to run in to a fellow Burg nurse this way.
It is my understanding that C Diff occurs naturally in all of our GI tracts. It is only when we take antibiotics that our normal balance of bacteria is upset and the C Diff proliferate, wreaking havoc. We isolate C Diff pts to prevent transmission to immunocompromised pts.
for so many reasons:
shock-me-sane
534 Posts
this post scares me.