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Clostridium difficile-Associated Disease (CDI)

Clostridium difficile, or C Diff as it is often referred to in the media, is one of the many kinds of bacteria that live in the intestinal tract of healthy people. Normally, C difficile does not cause disease. However, taking antibiotics can kill the other types of bacteria living in the healthy intestine, allowing C difficile to reproduce in large numbers. C difficile begins secreting a toxin (poison) that causes irritation of the bowel and diarrhea. C difficile is also referred to as an antibiotic-associated diarrhea. CDI is usually mild but sometimes can be severe. In severe cases, surgery may be needed, and in extreme cases CDI may cause death.

How does C difficile spread?

C difficile is infectious. People who have the illness can spread it or it can be present on environmental surfaces, such as toilets, handles, bedpans or commode chairs. When touching these items our hands can become contaminated. If our unwashed hands then come in contact with our mouth, there is a possibility of becoming infected Our soiled hands can also spread the bacteria to other surfaces.

How do we track C difficile?

The microbiology department notifies the infection prevention and control department of every case of C difficile. Patients with CDI are placed in isolation and special precautions are taken to prevent the spread to other patients.

What do the indicators reported on our website mean?

The Ministry of Health has asked that each Hospital in Ontario report the ratio of patients that acquire C difficile while admitted to the hospital per 1000 patient days.

A “patient day” is defined as one patient staying in hospital for one day. If 10 patients are in the hospital for one day, that represents “10 patient days”. Alternatively, if one patient stays in hospital for 10 days, that is also “10 patient days”. When you look at our rates you will know that for each 1000 patient days, “X” number of patients developed C difficile-associated disease.

Clostridium Difficile Associated Disease (CDI)

Clinton Public Hospital

Month 2019 Rate 2018 Rate 2019 No. of Cases 2018 No. of Cases
January 0.00 1.73 0 cases <5 cases
February 0.00 0.00 0 cases 0 cases
March 0.00 0.00 0 cases 0 cases
April 0.00 0.00 0 cases 0 cases
May 0.00 0.00 0 cases 0 cases
June 0.00 0.00 0 cases 0 cases
July 2.26 0.00 1 case 0 cases
August 0.00 0.00 0 cases 0 cases
September  1.76 1 case
October  0.00 0 cases
November 0.00 0 cases
December 0.00 0 cases

St. Marys Memorial Hospital

Month 2019 Rate 2018 Rate 2019 No. of Cases 2018 No. of Cases
January 0.00 0.00 0 cases 0 cases
February 0.00 0.00 0 cases 0 cases
March 0.00 0.00 0 cases 0 cases
April 0.00 0.00 0 cases 0 cases
May 0.00 0.00 0 cases 0 cases
June 0.00 0.00 0 cases 0 cases
July 0.00 1.72 0 cases 1 case
August 0.00 1.70 0 cases 1 case
September  0.00 0 cases
October  0.00 0 cases
November 0.00 0 cases
December 0.00 0 cases

Seaforth Community Hospital

Month 2019 Rate 2018 Rate 2019 No. of Cases 2018 No. of Cases
January 1.63  0.00 1 case 0 cases
February 0.00 0.00 0 cases 0 cases
March 0.00 0.00 0 cases 0 cases
April 0.00 0.00 0 cases 0 cases
May 0.00 0.00 0 cases 0 cases
June 0.00 2.02 0 cases 1 case
July 1.64  0.00 1 case 0 cases
August 0.00 0.00 0 cases 0 cases
September 0.00 0 cases
October  0.00 0 cases
November 0.00 0 cases
December 0.00 0 cases

 

 

Stratford General Hospital

Month 2019 Rate 2018 Rate 2019 No. of Cases 2018 No. of Cases
January 0.00 0.30 0 cases <5 cases
February 0.75 0.70 2 cases <5 cases
March 0.34 0.00 1 case 0 cases
April 0.37 1.06 1 case 3 cases
May 0.34 0.00 1 case 0 cases
June 0.00 0.41 0 cases 1 case
July 0.73 0.37 2 cases 1 case
August 0.36 0.00 1 case 0 cases
September 0.00 0 cases
October  0.35 1 case
November 0.37 1 case
December 0.35 1 case

 

HPHA Combined Rate

Month 2019 Rate 2018 Rate 2019 No. of Cases 2018 No. of Cases
January 0.21 0.39 1 case <5 cases
February 0.47 0.44 2 cases <5 cases
March 0.21 0.00 1 case 0 cases
April 0.23 0.67 1 case 3 cases
May 0.22 0.00 1 case 0 cases
June 0.00 0.50 0 cases 2 cases
July 0.91 0.45 4 cases 2 cases
August 0.22 0.22 1 case 1 case
September 0.23 1 case
October  0.22 1 case
November 0.23 1 case
December 0.22 1 case

 

What special precautions does HPHA take to prevent the spread of C difficile?

  • Place patients in a private room with their own bathroom.
  • Staff wear gloves and a gown when entering the room
  • Staff use careful hand hygiene after removing their gloves upon leaving the patients room and before contact with other patients
  • Dedicate patient care equipment to the isolated patients
  • Communication to other departments that the patient may have to go for diagnostic testing or therapy and that this patient is in isolation. These departments will also wear gloves and gowns when working directly with this patient. Every attempt is made to accommodate this patient at the end of the day.
  • Food handlers never enter the rooms of isolated patients
  • When the patient is discharged, the room is completely emptied. Curtains are removed and all unused items are disposed of. The room is then cleaned first using a disinfectant followed by a bleach solution.

Good hand washing by everyone, healthcare providers, doctors, volunteers, patients and visitors, is the single most effective way to prevent the spread of infectious diseases like C difficile. The HPHA Infection control policy for C difficile is based on Provincial Infectious Diseases Advisory Committee best practise guidelines.