Quick Fix to Prevent Bacteria-Related Diarrhea in Hospital Patients

By: Mohsin Ali

It may be as simple as probiotics, suggests a study led by McMaster professor Dr. Bradley Johnston. His colleagues analyzed twenty randomized-controlled trials, totalling almost 4,000 patients. They asked whether the use of probiotics—‘good’ bacteria found in yogurts, powders, or capsules—influenced rates of diarrheal illness related to the bacterium Clostridium difficile. Their main finding: new cases of C. difficile–associated diarrhea in hospital patients was reduced by 66 per cent, amounting to 33 cases prevented per 1,000 patients.

This effect is significant given the burden of C. difficile on the healthcare system: it causes illness and death in hospitalized adults. In fact, almost half of all diarrheal illness in hospitals is associated with C. difficile, and it is a major concern for the Ontario Ministry of Health and Long-Term Care, too, who tracked 75 outbreaks in 47 hospitals from 2009–2011.

Dr. Johnston, who is also a clinical epidemiologist at the Hospital for Sick Children in Toronto, echoes these concerns. He noted that a 2010 University of Ottawa study found one patient for every 10 infected by C. difficile died of the infection, and therefore “[m]inimizing or even preventing C. difficile among vulnerable patients is a high priority for making every hospital as safe as possible for all patients. It’s an important public health issue.”

Dr. Mark Loeb, division director of Infectious Diseases in the Michael G. DeGroote School of Medicine at McMaster, agrees. As a co-author for the study, which was published in the Annals of Internal Medicine, both he and Dr. Johnston emphasized the importance of integrating probiotics into the diets of hospitalized patients. Older patients are especially at risk when using antibiotics, which deplete both ‘good’ and ‘bad’ bacteria, providing a niche for C. difficile to thrive.

Probiotics help reintroduce healthy bacteria, and though they are not a magic bullet, said Dr. Johnston, they are an effective, safe and relatively inexpensive approach to prevent C. difficile–associated diarrheal illness.