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A Very Personal Bacterial Battle: C. Diff Killed UK Physician’s Stepfather

Uk’s Richard Greenberg is one of many doctors around the country working to halt an aggressive and increasingly fatal bacterial infection called C. diff, but he has a personal reason for wanting to see the fight won.

His stepfather, who lived in Washington, D.C,. died in 2005 from a severe case of C. diff.

Health officials say an aggressive new strain of the infection is causing a growing national health threat, producing fatigue, nausea, raging diarrhea and, in rare cases, death. C. diff outbreaks have been reported at hospitals in Canada and several U.S. cities.

A study of C. diff (formally known as Clostridium difficile) in a dozen Quebec hospitals in 2004 found an incidence of 22.5 cases per 1,000 hospital admissions and a mortality rate of 6.9 percent—rates that The New England Journal of Medicine recently called “strikingly high.”

Greenberg, an infectious diseases expert and a professor of medicine at UK, is testing an experimental new vaccine that might protect patients against C. diff and prevent devastating relapses. Developed by Acambis Inc. in Massachusetts, the vaccine is designed to boost patients’ natural immunity against the disease.

The infection has been striking increasing numbers of hospital patients who have received courses of powerful antibiotics. It is thought that these patients either pick up the bacteria in the hospital or already have C. diff in their bodies. Then, so the theory goes, the antibiotics they receive knock out helpful bacteria in the colon that normally would keep C. diff in check. Without them, the infection takes off.

People whose immunity is strong might escape with only a bout of diarrhea. Those with lower immunity might need repeated oral antibiotic treatments to control the infection and prevent relapses, Greenberg explains. In rare cases, severe, life-threatening infections develop.

“This is what happened to my stepfather. He had the diarrhea and lacked the innate immunity. He was treated too late: By the time it was recognized, his colon had been destroyed. They had to remove it, and he never recovered from the surgery.”

Greenberg says patients who develop severe diarrhea within a few weeks after spending time in the hospital or taking a course of antibiotics should call their doctor immediately.

Greenberg plans to give the vaccine to healthy people to determine whether it boosts their natural immunity against C. diff. He hopes to recruit a small number of healthy patients over age 65, who would receive three injections of the vaccine at 28-day intervals. If things go well, the vaccine eventually would be offered to patients who are infected with C. diff, he says.

“Eventually, it might prove cost-effective to give the vaccine to all patients who are going to get any procedure in the hospital and who will be receiving antibiotics.”

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