In May 2008 the Ministry of Health and Long Term Care in Ontario announced that there would be public reporting by Ontario Hospitals on their rates of an infection called Clostridium difficile (C. difficile). This reporting will commence on September 30, 2008.
Clostridium difficile is a bacterium that may cause diarrhea* or more serious life-threatening conditions such as severe colitis. C. difficile is the most common cause of infectious diarrheal disease in modern hospitals of the industrialized world.
C. difficile can also be found in up to 5% of adults and cause no symptoms or health problems. A person who carries this bacterium in the bowel and has no symptoms is said to be ‘colonized’ with C. difficile. Hospital personal can also ‘colonize’ the bacterium on their hands. Environments such as in hospitals or long-term care facilities can also become contaminated with the bacteria. The spores that the bacteria produce are resistant to destruction and can live on surfaces for months. Very specialized chemicals are required to clean these environments.
Once a person is exposed to C. difficile and the normal ‘good’ bowel bacteria is changed or killed (often through the use of antibiotics) C. difficile can take over. C. difficile produces dangerous toxins which cause the diarrhea or colitis.
Individuals who are at increased risk for acquiring Clostridium difficile associated diarrhea (CDAD) are those who:
- Have taken antibiotics
- Had bowel surgery
- Are on chemotherapy
- Have been in hospital for a long time
Other factors are:
- Increased age
- Other serious illnesses
Persons with CDAD will be encouraged to use meticulous hand hygiene practices, especially after using the washroom. Please refer to http://www.tbdhu.com/ID/HandWashing.htm
* Diarrhea is defined as three or more loose/water bowel movements in a 24 hour period, are unusual or different for the person and there is no other explanation for the diarrhea such as laxative use or known inflammatory bowel disease.
Outbreaks of C. difficile:
Outbreaks of C. difficile in Canadian hospitals have been reported in the media over the past few years. An ‘outbreak’ is defined as an increased number of cases exceeding the normally expected rate for that hospital or facility during a specified time.
Outbreaks of any gastroenteritis including C. difficile are to be reported to the local public health unit as required by the Health Protection and Promotion Act, Ontario Regulation 559/91.
Patient Information:
For more information see the Ontario Ministry of Health--Clostridium difficile: Fact Sheet for Patients at: http://www.health.gov.on.ca/english/providers/program/infectious/diseases/ic_cdiff.html
Health Care Professionals:
The Ontario Ministry of Health provides both a Best Practice document and further information at the following site:
http://www.health.gov.on.ca/english/providers/program/infectious/diseases/ic_cdiff.html