By Doug Fletcher,Staff Writer

A deadly germ commonly seen in people on antibiotics has been found in Maine hospitals and elsewhere around the country.

The bacterium, Clostridium difficile, also known as C. diff, causes diarrhea. In some cases, the diarrhea can linger and intensify, resulting in perforated colons and in extreme instances, death.

Typically, C. diff shows up in hospital patients or people recently discharged from hospitals. A study of the germ led to three research reports released last week by the nation’s Centers for Disease Control and Prevention and the New England Journal of Medicine.

The reports showed that the illness caused by the bacteria is becoming more common.

“We’re very concerned about this,” said Dr. L. Clifford McDonald, the CDC’s lead researcher on the studies.

The germ appears to mutate in part from the overuse of certain antibiotics. Its development, say researchers such as McDonald, is another reason people should use antibiotics as judiciously as possible.

McDonald said information from two of Maine’s 39 acute care hospitals were included in researchers’ evaluations. He declined to name the hospitals.

Dr. Dale Gurting, a researcher who collaborated with McDonald, also declined to name the hospitals. He said they participated in the study on a voluntary basis. Without approval by the institutions, he and McDonald said they couldn’t breach the hospitals’ confidence.

Gurting, however, said the strain of C. diff cited in the study has become widespread on the East Coast. It’s likely that nearly every hospital in New England has had experience with it.

“It’s pretty much universal,” said Dr. Andy Pelletier. “It’s a real problem.”

Pelletier, a specialist with the Infectious Disease Division of the Maine Center for Disease Control and Prevention, a unit of the state’s Department of Health and Human Services, said Thursday that while C. diff is rampant, it isn’t a reportable disease. As a result, Maine doesn’t have solid statistics on just how often it occurs.

Higher risk

McDonald said people would be wise to do two things if they hope to avoid the bug. One, he said, is to wash hands thoroughly, particularly in hospital settings or at homes where someone has been recently discharged from a hospital.

“Hand-washing is the most effective way of preventing transmission” of C. diff, Pelletier said. The same holds true for many other contagious diseases.

McDonald’s other suggestion: Question your physician about C. diff before a hospital stay and what steps are in place to avoid it. In particular, inquire about antibiotics that may be prescribed and their effect on the body’s many beneficial bacteria.

C. diff typically shows up in patients who are taking antibiotics for other illnesses. The antibiotics kill microbes that tend to keep C. diff under control.

Pelletier said hospital patients tend to be at higher risk of getting C. diff in large part because their immune systems are sometimes already compromised and they tend to be receiving large doses of antibiotics.

The researchers noted that a particularly severe outbreak of the germ in 2003 in Quebec is believed to have killed nearly 200 people.

C. diff showed up at St. Mary’s Regional Medical Center in Lewiston in 2004, said Jennifer Radel, a hospital spokeswoman. Because of the Quebec outbreak, infectious control experts at St. Mary’s had been watching for it.

They immediately implemented CDC recommendations to control the bug. Those actions included changing the type of disinfectant used by the hospital, stepping up education for employees and patients regarding hand-washing and altering drug therapy when appropriate.

Radel said that with the preventive measures in place, the incident level of C. diff declined.

Central Maine Medical Center in Lewiston didn’t immediately respond to an inquiry regarding C. diff there.