Enfield hospitals are under pressure to do more to stop patients contracting a potentially fatal infection.

Clostridium difficile (C. difficile) claimed the lives of two patients at North Middlesex Hospital in Sterling Way, Edmonton, this year while at Chase Farm Hospital 159 cases were reported between July and September.

The hospital-acquired bug, which attacks the body, causing chronic diarrhoea and fever, claimed the lives of 1,000 people across England in 2003, figures show.

More than 44,488 cases were reported in those over 65 during 2004.

A survey carried out by the Health Protection Agency and the Healthcare Commission revealed only a third of all trusts routinely follow Government guidelines on C. difficile management.

Questionnaires received from 118 out of 173 trusts showed: Thirty-eight per cent of trusts do not have restrictions on the use of antibiotics one of the key stepsthey can take to reduce the risk of C.difficile More than a third of trusts are unable to routinely isolate C. difficile patients, while 40 per cent of trusts do not consult communicable disease control during an outbreak Two thirds of trusts believed incidents of C. difficile had risen over the past three years.

Marcia Fry, who headed up the survey for the Healthcare Commission said: "It is deeply worrying a significant number of trusts are not managing to implement existing guidance on C.difficile.

"We recognise these outbreaks are not easy to control, but trusts must do more to ensure they have systems in place to protect patients from this potentially lethal infection."

In October North Middlesex Hospital Trust was accused of gross negligence when two patients died and around 30 fell ill after contracting C.difficile.

Caterina Cotrulia, 93, and Violet Scott, 84, died after being admitted to the Michael Bates Ward. Investigations have been launched.

A trust spokeswoman said: "North Middlesex Hospital has made significant improvements in reducing the number of infections across the hospital.

"Levels of C.difficile at the hospital are well below the national average. Figures for the last two months show there were 15 cases in November and seven cases in December.

"The trust has policies on the use of antibiotics and also carries out infection-monitoring to take action should levels increase.

"C.difficile patients are isolated, however, we do recognise the need for more isolation facilities and the £100 million redevelopment of the hospital will help us to improve in the future."

A spokesperson for Chase Farm Hospital said: "All new staff receive infection control education and training as part of their induction.

"In addition on-line training will be rolled out in the New Year.

The interim results were published this week, prior to the peak time for C.difficile infections.

A full report is due in the spring.