A SERIOUS infection rampant in Britain’s hospitals has been linked to the deaths of more than 1,700 patients, leading to renewed concerns about the cleanliness of wards.

Clostridium difficile was involved in more than 44,000 infections among over-65s last year, the first official data has shown. As a cause of death it now rivals MRSA and has risen more than 40-fold since 1990.

The bug was listed in 1,748 death certificates in 2003, and noted as the cause of death on 934 of them.

The new figures, from the first year of mandatory surveillance of C. difficile infections, also show huge variations, with some hospitals reporting hundreds of cases and a few none.

Gordon Lishman, the director-general of Age Concern England, said: “The very high rates of this appalling infection will worry many older people as they are the biggest users of the NHS and are most likely to be exposed to it.

“Many hospitals are clearly not doing enough to keep the wards safe and clean. Hospitals should be complying with new core standards on hygiene but we fear that some may be flouting these.”

Mandatory recording of C. difficile only began in January last year, so there is no basis for deciding whether actual levels are increasing or whether the infection is simply being more widely detected.

But the figure for 2003 produced by the Health Protection Agency as a result of a voluntary reporting scheme was 35,536 cases.

The actual figures for 2004 of 44,488 suggest that the sharp increase in the number of cases is continuing. Another 20 per cent can be added to that figure, because the cases that occur in under-65s were not counted.

C. difficile is not a superbug resistant to antibiotics, but part of the normal bacterial flora of the gut. It is found in about 3 per cent of healthy adults.

It becomes a problem when other gut bacteria are killed by antibiotics. Then C. difficile can proliferate, causing diarrhoea and, in some instances, severe inflammation of the bowel.

Those at greatest risk include patients who have had gastrointestinal surgery, who have spent a long time in hospital, have been treated with antibiotics, or who have a serious underlying illness.

C. difficile can cause outbreaks in hospitals because those with the infection shed long-lived bacterial spores in their faeces, which can persist on surfaces and be transmited on the hands of health workers.

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