toh

July 8, 2011 – C. difficile is just one of the many types of bacteria that can be found in the environment and the intestines. For most people, it does not pose a health risk. However, C. difficile associated disease (CDAD) can sometimes occur when antibiotics are prescribed. Antibiotics work by killing off bacteria – the bad bacteria – but also good bacteria. This can allow the C. difficile bacteria to multiply, which may cause diarrhea and can damage the bowel.

CDAD is the most common cause of infectious diarrhea in healthcare facilities. The effects of CDAD are usually mild but can sometimes be more severe. In severe cases, surgery may be needed, and in extreme cases CDAD may cause death.

Rates of C. difficile are the first of eight patient safety indicators that hospitals are required to publicly report. All of these indicators are posted on the Ministry of Health and Long-Term Web site and on each hospital’s own Web site.

The public reporting builds on other initiatives such as Just Clean Your Hands – a hand hygiene program launched in March 2008, and the creation of 14 Regional Infection Control Networks across the province.

C. difficile rates, as is the case for all infections, can fluctuate over the course of a year for a number of reasons. For example in winter, we admit more patients with respiratory infection than at other times of the year. An increase of respiratory infections often results in more antibiotics being prescribed, a leading factor in new cases of C. difficile.

An increase in the rates of C. difficile may also be related to periods of increased occupancy levels. An increased number of patients mean that more patients are being cared for closer together. Close physical proximity can result in C. difficile being spread more easily.

When we experience cases of C. difficile, they are usually contained in a limited geographic area or unit of the hospital. Patients and families should know that compared to the overall number of patients admitted each year, these cases are relatively low in number.

The Ottawa Hospital pays close attention and follows a number of procedures to manage C. difficile:

• Isolating individuals identified or suspected to have C. difficile, wearing gowns and gloves to enter their rooms.
• Ensuring that all patients suspected of having C. difficile in hospital are tested.
• Reminding all staff of the importance of proper hand hygiene.
• Ensuring proper cleaning of all patient rooms, including rooms of C. difficile cases.
• Ensuring that visitors are instructed in hand washing and other control measures.
• Providing education where needed so that all members of our team are up-to-date with current management strategies.
• Ensuring that all patients with C. difficile infection are appropriately treated.

Please contact us using our feedback form if you have any questions about C. difficile.