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Taking three or more kinds of antibiotics to fight an infection can raise your risk of a potentially deadly infection with Clostridium after surgery up to twelve-fold. Here's what you need to know to minimize risk.

The genus Clostridium includes more than 60 species of especially aggressive bacteria. They produce a variety of infections that few other families of bacteria can match. Unlike most opportunistic infections that take advantage of damaged immune systems,  Clostridia strike people with active immune systems.

Clostridia grow in the absence of oxygen. They produce a dizzy array of potent toxins. One species of Clostridium produces the deadly botulinum toxin, the cause of potentially fatal food poisoning, but also the nerve paralyzing agent Botox. The species Clostridium perfringens can produce another dozen bacterial byproducts that can irritate the colon and destroy tissue.

For most of the twentieth century, Clostridia were mostly associated with gangrene in wounds and massive infections after back alley abortions. Medical journals were filled with lurid reports about patients with deadly illnesses caused by rotting tissue. In recent years, however, Clostridium species have become even better known as the source of infections acquired in hospitals.

The Explosive Spread of Infections with Clostridium dificile

One particular species of Clostridia has become a major problem for Americans at large. Clostridium dificile is associated with an especially unpleasant form of diarrhea. Usually contracted in a hospital, these bacteria trigger an especially unpleasant form of diarrhea. First there is intense abdominal pain. Then the bowels empty themselves of their entire contents, usually explosively. Then there can be intense sweating, difficulty breathing, and even loss of consciousness – if the patient is lucky. In the most severe cases, the bacteria can destroy tissue in the bowel, leaking into the bloodstream, causing a condition called septicemia, which is rapidly fatal if not controlled by intravenous antibiotics which have to be administered in a hospital. Tissue damage is especially problematic if the infection is acquired in a hospital during recovery from bowel surgery.

Up to three million people every year in the United States alone catch Clostridium infections while they are in the hospital. Between 2000 and 2009, the number of people in the United States who had to be admitted to hospital just for Clostridium infections increased from 139,000 to 336,000. Clostridia strike about half as many people in Europe, and even fewer in India and the rest of Asia, but is more common in parts of Canada (especially Quebec) than in the USA.

Who Is Susceptible to Clostridium Infection?

Clostridium infections are most common in newborns and in people over 60, but babies usually don’t develop diarrhea or other symptoms of the disease. They can, however, transmit the disease in dirty diapers. Until recently, most people over the age of one year and not yet senior citizens did not catch the infection unless they had inflammatory bowel disease or immune deficiencies, but recently there have been two disturbing trends:

  1. Many people who wouldn’t have been expected to catch Clostridium are coming down with the disease, and
  2. Antibiotics that once controlled the infection no longer work.

Even worse, antibiotics to prevent other infections have been shown to increase the risk of infection with Clostridium. Three antibiotics are especially problematic.

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