St. Joseph’s, in consultation with Toronto Public Health, has declared an outbreak of C. difficile. This means we have had three months of continuous rates of health care-associated C. difficile infections over our baseline rate which meets the Ministry of Health and Long-Term Care’s criteria of a facility-wide outbreak.
What is C. difficile (C. difficile)?
C. difficile is one of many types of bacteria that can be found in feces (bowel movement). C. difficile occurs when antibiotics kill your good bowel bacteria and allow the C. difficile to grow. C. difficile produces toxins that can damage the bowel and may cause diarrhea. It can be mild, moderate or severe possibly requiring surgery and in extreme cases, C. difficile may cause death.
C. difficile is the most common cause of infectious diarrhea in hospital, though it can also be acquired in the community (someone can come into the hospital already having it). The main symptoms are:
- Watery diarrhea
- Abdominal pain or tenderness.
C. difficile usually occurs during or after the use of antibiotics. Older age (65+), presence of other serious illnesses and poor overall health may increase the risk of severe disease.
How is C. difficile spread?
The bacteria in the stool can contaminate surfaces such as toilets, handles, bedpans or commode chairs. When we touch these items with our hands, they become contaminated and if we then touch our mouth without washing our hands, we can become infected. Soiled hands can also spread the bacteria to other surfaces.
How will my doctor know if I have this?
If you have symptoms of C. difficile, your doctor will ask for a sample of your watery stool. The laboratory will test the stool to see if C. difficile toxins are present.
Should I be concerned?
Patient, staff and visitor safety is our top priority. C. difficile can be acquired both in the community and in hospital/health institution settings. However, C. difficile outbreaks are not uncommon in hospitals. That’s why we take very seriously our ongoing commitment to prevent hospital-acquired infections, and when they do happen, take every possible measure to stop their spread.
Are you suspending any services or visiting hours?
No. At this time, there is no impact on patient admission or transfer to or from the Health Centre, no restrictions on students or volunteers, and no changes to our visitor policy.
How is C. difficile treated?
Treatment depends on how sick you are. C. difficile is typically treated with a specific type of antibiotic. In very severe disease, surgery can be required.
How can one prevent spread of C. difficile?
Cleaning hands is the most important way for everyone to prevent the spread of C. difficile. Proper use of hand sanitizers and hand washing with soap and water is very important to prevent, and during, any outbreak.
What are you doing about the outbreak?
We are regularly reviewing the status of the outbreak and ensuring that we are doing everything we can to prevent further spread and to work toward reducing the number of new and active cases. A number of important measures have been implemented, including:
- Enhanced environmental cleaning of rooms and equipment, including the use of a sporicidal disinfectants, a best practice among hospitals;
- Increased education for patients, visitors, staff and physicians around hand hygiene while in the Health Centre;
- Ongoing stewardship of appropriate antibiotic prescription and use; and
- Enhanced surveillance for difficile by all health-care workers involved in patient care.
What will happen if I’m an inpatient and I have C. difficile?
If you have C. difficile, you will be put on special precautions until you are free from diarrhea for at least two days. You may be placed in a single room with your own washroom. Your activities outside the room may be restricted. All health-care staff providing direct care to you must wear a gown and gloves. Family or visitors providing care to you must also wear gown and gloves to prevent spread of the disease. Washing hands is a must in this situation.
If I’m a patient or a visiting family member, what else can I do to prevent C. difficile?
The single most effective way to prevent the spread of infectious illnesses in the Health Centre is through proper hand hygiene practice. Always wash your hands with soap and water after using the bathroom and before eating. Visitors may be asked to check in with nursing staff if they have not done so already and may be asked to wear protective gowns and gloves during the visit.
Please see C. difficile rates for more information.