Kent trust faces £1.5m-plus fine after failing to control C.difficile

Maidstone and Tunbridge Wells NHS Trust already exceeds annual infection allowance with three weeks to go

C.difficile is the leading cause of hospital-acquired diarrhoeal disease in the UK

NHS organisations are stepping up infection prevention measures after it was announced that a Kent trust will be fined at least £1.5m after missing targets for controlling the potentially-lethal infection, C.difficile .

Like all health providers, Maidstone and Tunbridge Wells NHS Trust was set an annual limit for C.diff cases - in its case 49 up to the end of March this year. But figures reveal that, with three weeks still to go, 52 incidents have so far been recorded.

The infections were reported at Maidstone Hospital and Tunbridge Wells Hospital, but although the figures exceed the target, the trust said it has reduced incidents by 19% on last year.

The revelation will see the trust facing hefty fines of £500,000 for every case above its allocated target.

Cases are now at their lowest level for six years and we continue to do every possible to ensure patient safety

C.difficile can cause inflammation of the bowel, particularly among people who are taking antibiotics to treat other infections, or if a patient’s immunity is lowered by chronic or serious ill-health, surgery or drugs. Symptoms range from a mild tummy upset to severe painful bloody diarrhoea. Other symptoms include fever, loss of appetite, nausea and abdominal pain. In serious cases where patients have very low immunity it can prove fatal.

This is not the first time the trust has been affected by outbreaks. Between 2004-2006 at least 90 patients died at Maidstone Hospital.

But trust bosses insist they are taking infection prevention and control seriously and that less than one in every 1,000 patients admitted to its hospitals is infected. It adds that in almost every instance the infection was caused by antibiotic use.

Dr Sarah Mumford, the trust’s director of infection prevention and control, said: “We want to reassure patients that we are continuing to significantly reduce cases of C.difficile in our hospitals and that cases continue to be at an all-time low.”

While excellent hygiene remains absolutely essential, the full force of the trust’s fight has turned towards antibiotics both as a cause and a cure

She added that in 2006, around 70 patients a month being treated at the trust’s hospitals were found to be infected with C.difficile . Currently, there are less than five cases each month.

“While excellent hygiene remains absolutely essential, the full force of the trust’s fight has turned towards antibiotics both as a cause and a cure,” she said.

“Between 3% and 5% of people carry the C.difficile bacteria harmlessly in their gut flora. Broad spectrum antibiotics can wipe out good bacteria in the gut, leaving the C.difficile bacteria to grow, produce its toxin and cause the infection.

“This means that in all but one of our cases, patients are likely to have been carriers of the C.difficile bacteria before their admission to hospital and their infection has been triggered by the potentially life-saving antibiotics they needed.

“We are using targeted antibiotics to treat known C.difficile carriers and are limiting the use of other broad-spectrum antibiotics that can cause the infection. Cases are now at their lowest level for six years and we continue to do every possible to ensure patient safety.”

Companies