The Niagara Health System today declared a C. difficile outbreak at the St. Catharines General Site’s Oncology Medical/Palliative Unit.
Five patients on the unit have confirmed positive for hospital-associated C. difficile in the last two weeks. Under our infection prevention and control protocols, this means the unit is considered to be in outbreak. Four affected patients remain on the unit, and there have been no deaths associated with the outbreak. There are no other C. difficile outbreaks at the NHS.
“We have stringent infection prevention and control protocols at all of our sites, and our doctors, staff and volunteers work extremely hard to follow these best practices,” says Dr. Joanna Hope, Interim Chief of Staff. “We are doing everything we can to get out of this outbreak as quickly as possible.”
NHS is in regular contact with infectious disease specialist Dr. Michael Gardam. Dr. Gardam is Director of Infection Prevention and Control for the University Health Network in Toronto and a recognized expert in Canada for infection prevention and control.
“I consult with the infection prevention and control team at the NHS every week, and the hospital has put a number of innovative measures in place to minimize spread and control C. difficile,” says Dr. Gardam. “Superbugs like C. difficile are an ongoing battle for all hospitals and will always be a challenge.”
Our enhanced practices were put into place at all NHS sites in 2011 based on consultation with Dr. Gardam and other experts. These practices include heightened monitoring for C. difficile, increased housekeeping and nursing resources, increased hand hygiene audits, and an ongoing review of our use of antibiotics, which can be a factor in patients developing C. difficile.
Everyone visiting any of our hospital sites is reminded to clean their hands regularly. Please do not visit if you are sick.
Caroline Bourque Wiley
Phone: 905.378.4647 ext. 43113
Dr. Michael Gardam
Director of Infection Prevention and Control
University Health Network
Clostridium difficile infection at a glance
- Clostridium difficile is a bacterium that causes inflammation of the colon, known as colitis. C. difficile is widely distributed in the natural environment. It colonizes adults, most of whom are initially asymptomatic. Unlike other diarrheal illnesses, resolution of symptoms in patients with CDI takes longer.
- The exact percentage of adults colonized with C. difficile is unknown, but the number is suspected to be higher than previously thought due to factors such as potential transmission and/or colonization through foods, contact with pets, etc. Given this reality, a number of cases that appear to have been contracted in a hospital setting are in fact, the result of existing colonization with health care processes and treatments (e.g. antibiotics, chemotherapy, consequences of surgery) being responsible for unleashing the infection.
- C. difficile is an opportunistic pathogen. There is a link between antibiotic exposure as a trigger in the right host, rendering the notion of “incubation period” less relevant with this organism – i.e. using strong antibiotics, sometimes to save a patient’s life, will create an environment for existing C. difficile to ‘take over’ in a patient’s colon
- Management of patients with C. difficile infection focuses on appropriate use of isolation, hand hygiene and environmental cleaning.
- Prevention of C. difficile infection focuses on a multi-faceted strategy including appropriate use of antibiotics, and infection prevention strategies, including the use of routine practices, hand hygiene, prompt detection of acute diarrhea with isolation and testing for C. difficile, and environmental cleaning.
Adapted from materials from Public Health Ontario
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