The incidence of the potentially deadly bacterial infection known as Clostridium difficile doubled in hospitals from 2001 to 2010, researchers report, and leveled off from 2008 to 2010.

Clostridium difficile is a hospital-acquired infection linked to 14,000 deaths a year. According to the Centres for Disease Control and Prevention, the main cause is the overuse of antibiotics.

Using hospital discharge data on about 2.2 million people, average age 75, the scientists found that about a third had a principal diagnosis of C. difficile infection. Two thirds had other primary diagnoses. Incidence increased to 8.2 per thousand in 2008, the peak year, from 4.5 per thousand in 2001. It then decreased slightly though 2010.

Death rates declined over the period among patients with primary C. difficile infection, but it increased among those with a secondary diagnosis. Almost 9 percent of patients with a secondary diagnosis died, compared with 3.6 percent of those with a primary diagnosis. The study appears in the October issue of The American Journal of Infection Control.

Most health-care-associated infections have been declining, said the lead author, Kelly R. Reveles, an assistant professor at the University of Texas at Austin’s College of Pharmacy, “but C. diff is harder to control because the primary risk factor is antibiotic exposure. We’ve made improvements in infection control, but further efforts are necessary in improving antibiotic use.”

Medicine Allergies Often Deadly

The most common cause of fatal allergic reactions in the U.S. are medicines, especially antibiotics and radiocontrast agents used in imaging studies, a new analysis found.

Using data from the National Center for Health Statistics, researchers found 2,458 cases of fatal anaphylaxis from 1999 through 2010. Almost 60 percent of the deaths, or 1,446, were caused by reactions to drugs, and in cases where the specific drug was known, half were caused by antibiotics. The rate of drug-induced fatal reactions almost doubled over the period.

Insect stings caused 15.2 percent of the fatalities and food 6.7 percent. The cause was not recorded in a fifth of the cases.

The study, published in The Journal of Allergy and Clinical Immunology, also found that older age was associated with a higher risk from all anaphylactic reactions and that blacks had a higher risk of dying from drugs and food reactions. For insect sting deaths, rates among whites were almost three times as high as rates among African-Americans.

The lead author, Dr. Elina Jerschow, an assistant professor of medicine at the Albert Einstein College of Medicine in New York City, said part of the increase in drug-induced allergic deaths was probably because of changes in the way deaths are coded on death certificates. But, she added, “We are using more imaging studies than other countries, and they’re potentially life-threatening.”

Smell as a Predictor of Death

A defective sense of smell appears to be a good predictor of dying within five years, a new study has found. Researchers tested a nationally representative sample of 3,005 men and women ages 57 to 85 on their ability to identify five smells: rose, leather, orange, fish and peppermint. The study appears online in PLOS One.

They controlled for many factors – age, sex, socioeconomic status, smoking, alcohol intake, education, body mass index, race, hypertension, diabetes, heart attack, emphysema, stroke and diet. But still, people who could not detect the odors were more than three times as likely to die within five years than those who could. The lower their scores on the odor test, the more likely they were to die. Only severe liver damage was a better predictor of death.

The researchers believe that the decline in the ability to smell is an indicator of some other age-related degeneration, and is not itself a cause of death.

The lead author, Dr. Jayant M. Pinto, an associate professor of surgery at the University of Chicago, said that loss of smell should not be ignored. “There are treatable causes of olfactory loss,” he said, “so if people have problems, they should get evaluated. This is a gross indication of your health, so if you’re having some trouble, you should see a doctor.”

New York Times Service

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