St. Mike's taking extra measures to prevent spread of C. difficile
Toronto hospital has eight confirmed cases
Thursday June 5, 2008 -- Natalie Miller
From washing curtains and mattresses to increasing enforcement of staff hygiene practices, St. Michael's Hospital in Toronto is currently working “vigilantly” to prevent the spread of C. difficile.

The Toronto hospital had eight confirmed cases of the infection as of Wednesday afternoon. C. difficile is a contagious infection with symptoms ranging from diarrhea to colitis.

The small outbreak is confined primarily to the cardiovascular surgery unit and cardiovascular intensive care unit and the majority of cases can be traced to a single room, says Dr. Matthew Muller, associate medical director of infection prevention and control at St. Michael's Hospital.

He says while a certain number of cases are expected at hospitals, when that average number increases, in this case there were three cases determined in one ward in one day, it warrants further investigation.

So far, St. Michael's has learned two of the people acquired C. difficile in other hospitals and the other six acquired the infection at St. Mike's. Four of the cases are clearly linked to one room and the other two cases are still being investigated.

To stop the spread of infection, the Toronto hospital has isolated the patients confirmed to have C. difficile and is also isolating those who have diarrhea until testing confirms otherwise. As well, “We're monitoring all people who've had contact with the (infected) patients,” says Muller.

For those in isolation, the hospital has visiting restrictions in place. As well, staff members are wearing gowns, gloves and masks while providing care and washing their hands between patients, which are normal procedures that are being enforced. “We're reinforcing all of the things we normally do.”

“C. difficile is an unfortunate common problem in hospitals,” says Muller, noting St. Mike's has a good track record in terms of numbers of occurrences.

According to the Mayo Clinic, the bacterium C. difficile "causes one of the most widespread and potentially serious health care-associated infections acquired during a stay in a hospital or long-term care facility." According to the Centers for Disease Control and Prevention, each year in the United States, C. difficile is responsible for tens of thousands of diarrhea cases and at least 5,000 deaths.

When a person arrives at St. Mike's from another hospital or in emerg with diarrhea or acquires diarrhea while in hospital, contact precautions and testing are completed. When arriving from another hospital, healthcare centres are usually good at communicating if a patient being transferred has the infection. In this case, while still being studied, the person may have gone into relapse, which is common, says Muller.

The associate medical director says the situation is being monitored on a day-to-day basis.

“We are continuing to work vigilantly with staff to curb further spread of this outbreak of infection,” the hospital says.

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