July 20, 2014

On June 21, I had the opportunity to present to a group of more than 50 physicians and researchers, who are part of the Gulf Coast C. diff Collaborative (GCCC). Founded in 2012, GCCC is led by Texas Children’s Hospital’s Tor Savidge, associate director its Children’s Microbiome Center, and offers C. diff experts and young scientists an opportunity to share knowledge, best practices and emerging research. The Collaborative includes Texas Children’s Hospital, University of Texas-Houston, University of Houston, University of Texas-Arlington, University of Texas Medical Branch, Baylor College of Medicine, and Texas A&M.

The day was packed with presentations ranging from a “state of the art lecture” by Dr. Herbert DuPont, who leads the Center for Infectious Diseases at the University of Texas’ School of Public Health, to new research that suggests sleep aids like Ambien are a risk-factor for C. diff infections by Alex Peniche of the University of Texas Medical Branch.

Dr. DuPont’s talk captured many of the most pressing issues facing C. diff advocates. In particular, he noted that the death rate for people where C. diff was a contributing factor tripled from 2000-2005 and continues to do so. Dr. DuPont also noted a rise in nursing home deaths related to C. diff. Some other points of interest:

  • Official number of C. diff cases is grossly underestimated
  • “Community acquired” isn’t really from the community since most sufferers were recently in a healthcare setting
  • Individuals immune response to C. diff is very important as carriers have a natural immunity, whereas those who suffer multiple recurrences seem to never develop the antibodies
  • Diagnosis continues to be frustrating with some tests being overly sensitive and others not being sensitive enough
  • Lack of a national health service (i.e. “Medicare for All”) means that newer drugs like fidaxomicin are seen as economically prohibitive by many hospitals and insurers
  • More than half of CDI recurrences are from different strains of the bacteria and sufferers can have 3 or more present
  • Future research needs to focus on developing/refining optimal diagnostic tools, developing new therapies, optimizing existing therapies and understanding the mechanism of action that makes fecal transplants successful

Dr. Jonathan Crews of Texas Children’s Hospital review the epidemiology of pediatric C. diff and Sam Aitken of University of Houston shared his research into the significance of the NAP1, hyper-virulent strain on patient outcomes. Dr. M. Jahangir Alam presented on the extent to which C. diff is prevalent in the environment and that the NAP1 strain is dominant both in Houston, Texas and the United States. Dr. Alam noted that C. diff spores were found not only in healthcare environments but also in offices, businesses and homes throughout Houston.

My own presentation focused on how patients, physicians and scientists can work together to make C. diff infections rare, treatable and survivable, all goals that were shared with the Gulf Coast C. diff Collaborative. You can view my presentation here: “Igniting Physician and Citizen Collaboration to Fight C. diff.”

The Gulf Coast C. diff Collaborative is an excellent example of how physicians, scientists, public health experts and citizen advocates can work together to enhance each others’ work. I’m proud to have presented to this esteemed group, all of whom are committed to fighting C. diff from their unique perspectives. Check out the video below which features the Microbiome Center at Texas Children’s Hospital.

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