Gram-positive Clostridium difficile bacteria
(image courtesy of Janice Carr/CDC)

Clifford McDonald is a medical epidemiologist with the Centers for Disease Control and Prevention in Atlanta. He spoke today with Etopia Media Medical News Network from Taiwan about an emerging health threat, a more virulent, more drug-resistant strain of the Clostridium difficile bacterium (also referred to as C. difficile or even C. diff.).

In his interview, Dr. McDonald explained how C. diff. is a bacterium often present but medically-inactive in the human colon. When, as frequently happens, hospital patients are given powerful antibiotics for one reason or another (for example, to treat pneumonia) these agents destroy most of the friendly biological flora and fauna in the gut, but leave C. diff. relatively unharmed, and in a position to occupy the biological space now devoid of its usual microbial inhabitants.

The rampant C. diff., exuding toxins, can then cause diarrhea and colitis, to the detriment of the patient.

Problems generated by C. diff. have recently become worse. According to McDonald: "C. diff. has become resistant to antibiotics (the fluoroquinolones) that are increasingly and widely used for a variety of proven or suspected types of infection. This resistance in the C. diff. allows it to escape the action of the fluoroquinolones (e.g. Cipro, often used, post-exposure, against inhalational anthrax) while meanwhile some of these antibiotics effectively destroy the normal flora bacteria that normally protect against the action of C. difficile." Simultaneously, the gene that "down regulates" or keeps in check the production of the toxins that do the actual damage to the patient seems to have been knocked out in some new strains.

Taken together, this means that a stronger and more poisonous version of the C. diff. bacterium seems to have been created by the assiduous and concentrated use of antibiotics on hospital patients functioning as the biological substrate for these organisms' rapid evolution in the direction of increased survivability and increased lethality, neither of which are of benefit to current and future hospital patients.

Dr. McDonald suggests and specifies some hygienic procedures (more hand washing, more glove wearing) that could short-circuit the transmission cycle for C. diff..

He even acknowledges that consideration might need to be given to looking for non-antibiotic means of treatment to replace the current reliance on these wonder drugs. Of course, to the extent that modern medicine so heavily depends on antibiotics for all manner of treatments, this could mean a total re-evaluation of how modern medicine is practiced.

As Dr. McDonald points out, the case of C. diff provides a new twist on the long-running discussion about the need to reduce antibiotic use because it somehow nebulously and detrimentally affects "the community." Giving antibiotics is, he says, the "universal risk factor" in the genesis of C. diff. infections. Overuse of antibiotics in this case can immediately, directly, and negatively affect a doctor's own patient and, within the malpractice context, even immediately, directly, and negatively affect him- or herself.

These microscopic microbes are small, but they pack a big punch, which may not have completely landed yet.

You can hear the first half of the exclusive EMMNN interview with Dr. McDonald by clicking here.

You can hear the second half of the exclusive EMMNN interview with Dr. McDonald by clicking here.