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

Dr. Clifford McDonald is a medical epidemiologist with the Centers for Disease Control and Prevention in Atlanta, Georgia. He last spoke with Etopia Media Medical News Network on October 4, 2004, from Taiwan, where he was attending a medical conference.

In that interview, "Etopia Media Medical News Network #20: Hospital antibiotic use allows dangerous C. difficile to cause diarrhea and worse; profligate use encourages emergence of drug-resistant, more toxic versions," he discussed how a more drug-resistant and more virulent strain of the C. difficile bacterium had arisen under the evolutionary pressure provided by the common use of powerful anti-biotics, particularly in hospital settings.

In today's follow-up to this earlier interview, Dr. McDonald elaborates on some of the themes of his first conversation here and discusses some new approaches to treating C. difficile, including Ramoplanin, mono-clonal antibodies, toxin-binding agents, vaccination, and reducing the use of the anti-biotics that give rise to the infection in the first place.

He also discusses the use of disinfecting ultraviolet light as a way of reducing the presence of this and other microbes in the hospital environment.

In this interview, Dr. McDonald points out that the same problem of increased infection rates in patients on gastric acid-suppressing drugs, such as Nexium, Prilosec, and Zantac, applies not just to C. difficile and pneumonia, but comes into play with other food- and water-borne pathogens, such as E. coli, which can be acquired outside of a hospital setting.

With the newer anti-biotic, monoclonal antibody, and toxin-binding treatments still years away from application, Dr. McDonald says that C. difficile is likely to continue to spread in Canada and the United States, but, due to its predominantly nosocomial (hospital-induced) nature, is not likely to pose as large a general (pandemic) threat as such other diseases as common or avian influenza.

Dr. McDonald says that these outbreaks are helping to move the general approach of medicine in the direction of greater efforts to use vaccination and other means of enhancing the human immune system as a preferred means of defending against C. difficile and other infectious diseases.

You can hear Dr. McDonald's interview in its entirety by clicking here.