Big diff – poop wages war on diarrhea

Oh crap!

As one of the foremost “poop correspondents” on the internet it falls on me (no pun intended) to bring you this explosive story. Here’s my report filed from the trenches…

Recently, Brea thoughtfully tipped me off regarding some interesting news in the medical world. News that was right up my alley (so to speak).

To put this succinctly, poop transplants are now being performed as “last-ditch treatments” in the fight against an illness known as clostridium difficile or more commonly as “CDF/cdf” or “c. diff.”

According to Wikipedia, c. diff “is a species of Gram-positive bacteria of the genus Clostridium that causes diarrhea and other intestinal disease when competing bacteria are wiped out by antibiotics.”

The disease can be remarkably hard to treat and can be fatal. According to a story in the Associated Press, C. diff is “a germ that so ravages some people’s intestines that repeated tries of the strongest, most expensive antibiotic can’t conquer their disabling diarrhea.”

In dire cases, a new treatment consisting of a “transplant” of fecal matter from a healthy person is performed. A doctor in the story claims, “[fecal matter] is the ultimate probiotic.” (Probiotics are live microorganisms thought to be healthy for the host organism.)

I can only imagine how that doctor/patient consultation goes down. “Your problem, as you well know, is diarrhea. Our plan is to take poop from someone healthy and put it inside you. Poop will be the solution to your diarrhea.”

Sounds ass backwards to me.

It’s a little more complicated than that. The transplant procedure involves relocation of an “entire bacterial neighborhood” from the healthy donor.

Here’s the fun part. C. diff is thought to commonly be a “nosocomial infection.” That’s just a fancy way of saying the C. diff infection is often the “result of treatment in a hospital or a healthcare service unit.”

You go in for health care and come away with a little unplanned bonus. Interesting how that works, eh?

According to Wikipedia, a stay in the hospital up to two weeks represents a 13% chance to pick up the C. diff infection. A stay of four-weeks or more and that rate jumps to a whopping 50 percent!

I wish I was making this stuff up. All I can say is, “I’m not shitting you!”

As a poop correspondent, I’ve often sat around spending my free time daydreaming about things like hand washing rates. (Hand washing represents a substantial chunk of my “Poop Manifesto” I’m hoping to release someday.) We’ve all heard the stories about public handrails with more than 500 different sources of fecal matter on them. Or how people in public restrooms tend to wash their hands more often when they are being watched.

As a civilization we are apparently not big on the whole concept of hand washing and cleanliness. Even though science has told us about the dangers for a long time now.

Imagine a place where you think hand washing would reign supreme. Imagine people who you think would be best at it. It isn’t too hard to surmise that a place like an Intensive Care Unit (ICU) within a hospital might be such a place, right? And that people like doctors might be experts at washing hands, right? We’ve all seen the surgeons at Mash 4077 like Hawkeye, Trapper John and B.J. Hunnicutt “scrub” before working on patients. For them it was a big deal.

As it often turns out, it’s no big surprise (at least to me) when reality turns out to be just a wee bit different.

When doing my research, one thing I noticed was that the ICU industry (for lack of a better term) seemed to be bragging about hand washing rates of 97%. My reaction: How the hell is that something to brag about in a frickin’ hospital???

But it’s worse than that. Much worse. Studies have found that hand washing rates in ICUs are appalling low. Even after “awaresness campaigns,” specialized training, and even when employees are told that their hand washing will be monitored. And these are the people that take care of the sick?

One study found that within an ICU setting, there was a hand washing rate of 72.8%. Nurses were best with a rate of 97.5%. Technicians came in second with a rate of 47.7%. Are you ready to guess who came in last place? Yep, doctors, with a rate of 37.6%.

37.6%? Holy shit!

The study also found that an “educational program” about hand washing improved the hand washing rate among nurses and technicians, but not doctors. Said the study, “No statistically significant changes in the handwashing behaviour among doctors was observed during the study period.” Is this the “God complex” at work? Apparently doctors don’t like to be told what to do, about anything, from anyone. Oh, put your hands on me, doctor! And some people actually want to date doctors?

Side story: My wife worked in a doctor’s office. It was a small office where people sat a few feet away from the restroom. When someone did their business you could hear every “plop,” if you know what I mean. More importantly, however, you could hear if running water was turned on. Running water that would imply that hand washing was taking place. And guess who used the restroom and didn’t turn on the water before coming back out? Yep! The doctor! One of my favorite expressions used to be, “The doctor will fee you now.” But I think that’s old and busted. From now on, I’m updating my phrase to “The doctor will pee you now.” It think that’s a lot more apropos.

So, it seems to me, we just might have identified at least one culprit when it comes to nosocomial infections, eh? Do a serious internet search regarding the problem of simply getting health care workers to wash their hands and you begin to get an idea about the magnitude of the problem we’re facing.

The good news is that, since getting it’s humble start in hospitals and such, C. diff now seems to be making headway in the “outpatient setting,” also known as the general community outside of hospitals. You know, where people like you and me live our daily lives.

Humans! Is there anything they can’t do?

Thanks, Brea, for getting me started! 🙂

15 responses

  1. I actually saw this on a news website that I read every day, talking about a “superbug” that was stymieing doctors. No wonder, if they’re not washing their poop-laden hands!

    When I read about their treatment for this – your name was the first thing that came to mind. *sorry* 😀 I knew you’d be the one to really dig down to the “guts” of the story! NICE Post!

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    1. Thanks so much! I appreciate the inspiration. I really enjoyed digging out the dirt on this one.

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  2. Perhaps removal of a finger via pruner for each failure-to-wash infraction would be effective??

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    1. I think that might suffice. It would make it hard on the violator, however, to ever perform the five finger death punch. Pros and cons, I guess.

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  3. The only thing I can say is “You’re shitting me!”

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    1. You fit right in around here!

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  4. While I know considerably less shit than you do, I can say I know somebody who was on the receiving end of such a transplant.

    They used poo from her husband (cos if you can’t share your poo with your spouse, who can you?) and it helped…I guess. I mean, she’s fine now. She had a number of things going on and several surgeries over 4 months and ended up needing this poo-injection thing. It was the first I’d heard of it!

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    1. The technique seems to be promising, yet is still considered experimental. I hope the person you know makes a full recovery!

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  5. Thanks for giving me yet another reason to hate hospitals. Ew. Just, ew.

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    1. My pleasure.

      I would theorize that ICUs represent the very best of the best when it comes to hand washing rates. (And washing hands correctly, which is also muy importante.)

      It makes me wonder what hand washing rates are elsewhere, like, perhaps, a redneck bar? 🙂

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  6. I wonder where they get the donors. That fits right in with my skill set

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    1. My understanding is that they generally use spouses. After all, if you gotta swap poop, who better?

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  7. […] need a hot poop injection – stat!!! Luckily I have diarrhea of the mouth so that will help get this party […]

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  8. […] have also shown shocking hand washing rates in Intensive Care Units where employees have received training and motivation to wash their hands. […]

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  9. […] of this study becomes clear. Reminder: Intensive Care Unit (ICU) doctors are among the worst for hand-washing compliance rates. Good to […]

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