Clostridium difficile, a drug-resistant bacteria, is often found in hospitals but findings of a new study funded by the U.S. Centers for Disease Control and Prevention have revealed that a significant number of people who contracted the potentially deadly bug have not gone to the hospital but, instead, recently visited a dentist or a doctor.

In a new study published in the New England Journal of Medicine on Feb. 26, the researchers wanted to determine the number of C. difficile infections associated with health care facilities such as nursing homes and hospitals and the number of C. difficile infections that were contracted in the community. To do so they looked at related data in 10 areas of the U.S. in 2011.

The researchers found that 453,000 cases of the infection happened in hospitals and nursing homes but 150,000 cases were community-associated, which means that it occurred among individuals who had no recent exposure to a hospital or nursing home. They likewise found that majority of those who died were the elderly.

"About 80 percent of patients with community-associated C. difficile infection did have contact with health-care settings, like a doctor's office or a dental clinic, and most of those patients were also given antibiotics," said Michael Bell, from the CDC's National Center for Emerging and Zoonotic Infectious Diseases.

Bell said that 80 percent of the deaths occurred in individuals who were 65 years old and older. One in nine patients in this age group who got infected by the bug died within 30 days after they were diagnosed.

The researchers also estimated that the number of C. difficile infections in the country in 2011 was 453,000 with women, whites and the elderly who were at least 65 years old being the most likely to contract the superbug. They also found that in 2011 alone, 29,300 people died from C. difficile.

"A total of 15,461 cases of C. difficile infection were identified in the 10 geographic areas; 65.8 percent were health care-associated, but only 24.2 percent had onset during hospitalization," the researchers wrote. "The estimated number of incident C. difficile infections in the United States was 453,000."

Marc Siegel, from the NYU Langone Medical Center in New York City, said that improper sanitation in hospitals and overuse of antibiotics cause C. difficile to move into the community. Careful prescription of antibiotics and improved infection control in health-care facilities are crucial to curb C. difficile-associated infections and deaths, he said.

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