Ontario hospitals show lower C. difficile rates

TORONTO—Hospitals across Ontario reported 319 cases of the sometimes deadly Clostridium difficile infection last month, but the first mandatory report of the hospitals’ data does not include the number of deaths related to the bacterial disease.
The number of patients sickened by C. difficile in the province’s 157 hospitals works out to an overall rate of 0.39 cases for every 1,000 patient days—lower than the rates reported in Quebec and the United Kingdom, the Health Ministry said in releasing the August figures Friday.

Eight hospitals—most in the Greater Toronto and Golden Horseshoe areas—had the highest tallies with 10 or more cases, including Scarborough General Hospital in Toronto, which topped the chart with 17 for the month.
Hospitals will update their C. difficile case counts each month from now on, allowing a comparison of how well centres of a similar size are faring in preventing patients from becoming ill from the infection and stopping its spread within their walls.
Preventing patient-to-patient transmission of the bug—which produces infectious spores that can settle on skin, clothing, and equipment and are difficult to destroy—is one of the major goals of tracking the number of cases over time.
Health minister David Caplan said seeing trends in case counts will allow infectious disease experts to identify hospitals that may need help in improving C. difficile-control measures, such as programs to encourage better staff hand-hygiene, more thorough cleaning of patients’ rooms and medical equipment, and quicker identification of cases.
“But there is no quick fix,” he said. “Variations in the nature and capacity of hospitals means that it will take some time for surveillance and reporting to start producing a true picture.”
Caplan said Ontario is creating rapid response teams of infectious disease specialists that can be dispatched to any hospital with a C. difficile outbreak, defined as six cases on a single unit.
He also announced the hiring of 66 more infection control practitioners for hospitals and public health units.
Meanwhile, the new reporting system already has come under fire for painting an incomplete portrait of C. difficile in Ontario’s hospitals because it does not show how many people have died from infection-related disease.
NDP health critic France Gelinas said the mandatory reporting system is providing some new information, but said it falls short by not including mortality figures.
“It doesn’t really go very far to reassure Ontarians that going to the hospital is going to be a safe move for them,” Gelinas said in an interview. “We think that [reporting the deaths] gives you a much clearer picture.”
But infectious disease experts involved in setting up the system countered that no standards have been developed for determining whether a death was caused by C. difficile or from another illness for which a patient was being treated in hospital.
The disease typically affects older patients with multiple health conditions.