Thomas Birch, MD, an infectious disease specialist at Holy Name Medical Center, is an author of the lead article published today in the New England Journal of Medicine citing the results of a 2-year study on treating Clostridium difficile, commonly known as C diff. More than a half-million individuals in the U.S. develop this infection and about 29,000 people die from it each year.
The study, which tested the efficacy of an antitoxin, Bezlotoxumab, was conducted at 30 different centers across the nation, including Holy Name. Bezlotoxumab, which is a monoclonal antibody – meaning it is made by immune cells – was used in conjunction with an antibiotic to treat the recurring infection. Patients receiving the medication had a significantly lower recurrent rate than those given a placebo.
“C diff is a challenging infectious agent because it has a form like a seed and can persist in the gut and on surfaces outside the body for long periods of time,” said Dr. Birch, who is also head of the Infection Control Committee at Holy Name. “It can be resistant to antibiotics and disinfectants and produces a toxin which causes injury to the wall of the colon.”
The New England Journal of Medicine is among the most prestigious peer-reviewed medical journals published today. It receives nearly 5,000 submissions annually, publishing only about five percent of manuscripts. Each published article is reviewed and edited by at least five experts and a statistical analyst.
“This study is just one example of the type of cutting-edge clinical trials we do at Holy Name,” said Dr. Adam Jarrett, Medical Director at Holy Name. “Having it published in the New England Journal of Medicine shows the significance of the work being done here.”
C diff is caused by a bacterium but is typically held in check by normal bacteria found in the digestive system. Antibiotics taken to fight other infections may kill off these normal organisms, allowing C diff to develop. Different antibiotics are then used to fight the infection, making it difficult to treat and prone to recurrence. C diff causes inflammation to the gut wall, abdominal pain and watery diarrhea.
The study, which included 2,655 patients worldwide, focused on preventing recurrent C diff. The incidence of the infection is higher in people over 65 years old and most often occurs in patients in healthcare settings such as hospitals and nursing homes.
“The antibody augments the immune response to reduce the risk of recurrence,” Dr. Birch said. “Here at Holy Name we work on all fronts to control this infection: early diagnosis, treatment, isolation, hand hygiene, disinfection and appropriate use of antibiotics with this new medication and vaccine development.”
To read the article, visit nejm.org.