GOVERNMENT health inspectors are to investigate how Maidstone Hospital in Kent handled an outbreak of an infection that killed six patients and contributed to the deaths of fourteen others.

The Healthcare Commission announced an inquiry yesterday into Clostridium difficile, which it said followed concerns about the rates of infection at the hospital since 2004.

C. difficile is the main cause of diarrhoea infections in British hospitals, and contributes to more deaths than MRSA.

The inquiry into Maidstone and Tunbridge Wells NHS Trust will examine whether the rates of C. difficile are high, taking into account all factors. The investigation, one of only two the commission has conducted into C. difficile, will look at outbreaks of the infection and evaluate the trust’s systems and procedures for controlling it.

It is also likely to consider the trust’s arrangements for identifying and notifying cases, the factors contributing to the rates of infection, the trust’s response on the wards, and the priority given to its control.

The investigation was requested by the South East Coast Strategic Health Authority and the trust, whose three hospitals serve Maidstone and Tunbridge Wells and surrounding areas including Tonbridge, Sevenoaks and parts of East Sussex.

C. difficile can cause a wide range of symptoms, from mild diarrhoea to life-threatening conditions.

Nigel Ellis, head of investigations at the Healthcare Commission, said: “Our investigation will examine how the trust identified and dealt with cases of C. difficile.

“We recognise that outbreaks of infection are not always easy to control, but when they do happen they pose a very serious risk to patient safety.

“We need to find out what happened, what systems the trust has in place to ensure this does not happen again and whether further improvements are needed to protect the safety of patients.”

The commission, which is the independent inspection body for the NHS and the private and voluntary healthcare sectors, will publish its findings and recommendations for improvement in a report expected next year.

Maidstone is by no means the first hospital to suffer a serious outbreak of C. difficile. A total of 334 patients were infected with the bacterium and at least 33 died between October 2003 and June last year at Stoke Mandeville Hospital in Aylesbury, Buckinghamshire.

In a highly critical report into that outbreak, published in July, the commission said that there had been serious and significant failings in the way in which senior hospital managers had responded to it.

According to the Office for National Statistics, in 2003 there were 1,748 mentions of C. difficile on death certificates, of which 934 noted the infection as the underlying cause of death.

Between April and June, 136 patients at Maidstone Hospital were found to be infected with C. difficile, the trust said. The infection was the definite cause of death of six patients; in fourteen others it contributed to their deaths but was not the main cause, and it was unlikely to have led to the deaths of four other patients who had had the infection.

The trust said that it had implemented a range of additional measures to deal with the outbreak, including providing extra nurses and cleaners, changing its antibiotics policy, increasing infection-control measures and placing patients with diarrhoea in the most appropriate setting.

The number of patients with the infection is now believed to have returned to normal levels.

Rose Gibb, chief executive of Maidstone and Tunbridge Wells NHS Trust, said: “The trust takes the care and safety of its patients extremely seriously. It has approached the Healthcare Commission to independently and publicly scrutinise its handling of the C. difficile outbreak after listening to and working closely with members of the public on its own service review.

“The trust will now be working just as closely with the Healthcare Commission to identify, develop and implement any additional measures that can be made to further improve patient care and safety.”

A relative of one of the people who died from the infection told BBC South East Today: “I hope that (the investigation) will mean that less people are going to die, that you can bring your parents and children to the hospital and be able to come out and not catch a bug that’s going to kill.”

BACTERIUM WITH TOXIC POTENTIAL

A study in the Journal of the Canadian Medical Association says that patients on antibiotics but not in hospital were eight times more likely to develop C. difficile infections than others

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