Infection Control

Information on C Difficile

Reporting

On September 26, 2008, all Ontario hospitals will be required to report publicly on their rates and number of new hospital-acquired C difficile cases. Hospitals will also be required to report a variety of other patient safety indicators in the months ahead, including Methicillin-resistant Staphylococcus aureus (MSRA) and Vancomycin-resistant Enterococci (VRE).

Haldimand War Memorial Hospital takes your care and your safety very seriously, and we are committed to transparency.  On a monthly basis, beginning in September 2008, we will be reporting our C. difficile infection rates on our website. Our hospital strongly supports the provincial government’s new public reporting regime because we believe it will inspire improved performance, enhance patient safety, and strengthen the public’s confidence in Ontario’s hospitals.

Public reporting of our hospital’s C difficile rates will allow us to establish a baseline from which we can track our rates over time. If we feel our rates have risen above our baseline, we can look internally at our hospital’s processes, identify areas for improvement, and implement strategies to reduce the incidence of C difficile in our organization.

Measuring Clostridium difficile (C. difficile) rates

As previously stated, beginning on September 26, 2008, Haldimand War Memorial Hospital will post its infection rates online on a monthly basis.  On this website, you can find information about hospital-acquired infection rates for C. difficile. The rate is calculated by the number of incidents multiplied by 1,000 and divided by the number of patient days in the month.

What is C. difficile?

C. difficile (Clostridium difficile) is a bacteria.  C. difficile can be part of the normal bacteria in the large intestine and is one of the many bacteria that can be found in stool (a bowel movement).

A C. difficile infection occurs when other good bacteria in the bowel are eliminated or decreased allowing the C. difficile bacteria to grow and produce toxin.  The toxin produced can damage the bowel and cause diarrhea.  C. difficile has been a known cause of health care associated diarrhea for about 30 years.

Who is at risk for C. difficile?

Healthy people are not usually susceptible to C. difficile, Seniors, and people who have other illnesses or conditions being treated with antibiotics and certain other stomach medications, are at greater risk of an infection from C. difficile.

What are the symptoms of C. difficile?

The usual symptoms are mild but can be severe.  Main symptoms are watery diarrhea, fever, abdominal pain/tenderness.  In some cases there may not be diarrhea.  Blood may or may not be present in the stools.  If you are concerned, you should contact your family physician.

How do you get C. difficile?

C. difficile is the most common cause of hospital associated infectious diarrhea.  Since it can be part of the normal bacteria that live in the large intestine, taking antibiotics can change the normal balance of bacteria in your large intestine making it easier for C. difficile to grow and cause an infection.  Old age and the presence of other serious illnesses may increase the risk of C. difficile disease.

How does C. difficile spread?

When a person has C. difficile, the germs in the stool can soil surfaces such as toilets, handles, bedpans, or commode chairs.  When touching these items, your hands can become soiled.  If you touch your mouth, you can swallow the germ.  Your soiled hands can spread germs that can survive for a long time on other surfaces if not properly cleaned.

The spread of C. difficile occurs due to inadequate hand hygiene and environmental cleaning, therefore, proper control is achieved through consistent hand hygiene and thorough cleaning of the patient environment.  Good hand hygiene ie., washing hands thoroughly and often is the single-most effective way to prevent the spread of infectious diseases like C. difficile. Please refer to our website information on hand-washing.

How is C. difficile diagnosed?

Confirmation of C. difficile is done by laboratory testing.

How is C. difficile treated?

Treatment depends on how sick you are.  People with mild symptoms may not need treatment .  For more severe disease, antibiotics are required.

What precautions are used to prevent the spread of C. difficile in the hospital?

If you are in the hospital and have C. difficile diarrhea, you will be put in isolation until you are free from diarrhea for at least two days. All health care staff who enter your room will wear a gown and gloves.  Everyone must clean their hands when leaving your room.

How does Haldimand War Memorial Hospital control the spread of C. difficile?

Any patient who experiences symptoms associated with C. difficile is isolated and testing is done.  The patient will remain isolated until their tests are negative.

Does Haldimand War Memorial Hospital track C. difficile cases?

Monitoring is carried out on any patient who is diagnosed with C. difficile and reported accordingly.

What is Haldimand War Memorial Hospital doing to improve patient safety.

All patients admitted to the hospital from another facility are isolated and screened for a variety of hospital acquired infections and are monitored for symptoms of C. Difficile.  All patients are monitored closely and assessed regularly by a registered staff nurse.

HWMH continues its accreditation activities that ensure patient safety is at the forefront of everything we do.

For further information please speak to your health care professional or contact us through our  website.