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November 20, 2013

Hospitals use yogurt to prevent infections

Daily Briefing

Hospitals are experimenting with probiotics to prevent Clostridium difficile infections by protecting the bacterial balance in the intestines of patients being treated with antibiotics, the Wall Street Journal's Laura Landro reports.

C. diff—which can survive on surfaces like door handles and countertops—is the leading cause of hospital-acquired infections. While soap and water removes C. diff spores from skin, they do not respond to alcohol-based hand cleaners that are commonly used in hospitals. The bacterium also has resisted other infection-control strategies, including cleaning with bleach and isolating patients.

C. diff infection rates explode since 2001

Patients treated with antibiotics are particularly susceptible to the infection, as the medication weakens the immune system by killing off both good and bad intestinal bacteria. This can cause an imbalance in the intestine that allows C. diff to thrive.

Probiotics are contained in supplements and foods like yogurt; they help maintain the balance of bacteria in the intestines. The "live" bacterium is of growing interest because it helps maintain bacterial balance in the intestines and may be able to treat a range of medical conditions, including antibiotic-associated diarrhea.

Case study: Two yogurts a day keeps the C. diff away?

This year, Holy Redeemer Hospital in Meadowbrook, Pa., won an innovation award from the Hospital and Healthsystem Association of Pennsylvania for its probiotics program, which was proposed by a surgeon on the hospital's infection-prevention committee.

Beginning in January 2012, dietitians received a daily list of patients who had orders for more than one antibiotic a day. They met with each patient to discuss the potential benefits of probiotics, suggesting two six-ounce portions of yogurt daily. Kathryn Bromm, a clinical nutrition coordinator, says patients were "pretty agreeable" with the program recommendations.

As a result, C. diff infections decreased from 12.5% of patients in 2011 to just 4% in 2012.

The program's savings "more than compensate for the cost of the yogurt," says Jeanie Ryan, a clinical nutrition manager at the hospital.

More data may be needed

However, Washington University School of Medicine Erik Dubberke says there is not yet enough data to endorse probiotics for routine C. diff prevention in hospitalized patients. In some individuals, probiotics may actually cause infections, so "they are not entirely without risk," Dubberke notes.

However, he agrees probiotics are worth further investigation (Landro, Wall Street Journal, 11/17).

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