The October issue of the American Journal of Infection Control reports on a new study about a topic nobody really wants to think about — deadly diarrhea. It’s what happens when the otherwise harmless Clostridium difficile (C. difficile, or C. diff) digestive tract bacterium grows out of control, releasing toxins that attack the lining of the intestines and causing a condition called Clostridium difficile colitis. The healthy human digestive tract is home to as many as 1,000 microorganisms, most harmless and some helpful. What makes C. difficile turn toxic? Hospitals. C. difficile infections (CDI) in U.S. hospitals nearly doubled between 2001 and 2010 without any noticeable improvements in patient mortality rates or length of hospital stays. The study reported in the journal, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC), looked at 2.2 million C. difficile infections. Researchers from the University of Texas College of Pharmacy examined 10 years of discharge data and found that the C. difficile infection rate rose from 4.5 to 8.2 discharges of those with a history of the intestinal bug per 1,000 adults released from hospitals. “Several factors may have contributed to the rise in CDI incidence in recent years,” said Kelly Reveles, lead author on the study. “Antibiotic exposure remains the most important risk factor for CDI.” According to the Centers for Disease Control and Prevention (CDC), C. difficile is the most common bacteria responsible for healthcare-associated infections in U.S. hospitals and may account for 14,000 deaths each year. Reducing the use of high-risk broad-spectrum antibiotics by 30 percent could lower CDI by 26 percent, according to CDC estimates. There’s been a call for better antibiotic stewardship from national groups, including the White House. “It’s been estimated that up to half of antibiotic use in humans is unnecessary,” said APIC President Jennie Mayfield. “To make headway against CDI, hospitals and health facilities need to get serious about antibiotic stewardship.” Most CDI victims are female (59 percent), white (86 percent) and older than 65 (70 percent). An APIC survey found that 60 percent of U.S. hospitals had implemented antibiotic stewardship programs by 2013, up from 52 percent in 2010.