Clostridium difficile Associated Disease (CDAD)

C. difficile can be acquired within the hospital or from the community. The rate of C. difficile infection is calculated as a rate per 1000 patient days. The rate is calculated by taking the total number of new hospital acquired (HA) cases each month and dividing by the total number of patient days each month multiplied by one thousand. The total patient days represents a sum of the number of days during which services were provided to all inpatients during that given time period.

The rate is calculated as follows:
Number of new hospital-acquired cases of C. difficile in our facility X 1000
Total number of patient days (for one month)

The 2007 rate of hospital acquired C. difficile infection for Ontario participating in the Canadian Surveillance program was 0.82 per 1000 patient care days. Our rates have consistently been below these benchmarks.

“As recommended by the MOHLTC, the number of patient care days for C.difficle rates will differ from other infections posted with patient care days because children under of the age of one year are not included in C.diff reporting.”

C. difficile is a bacteria that can be found in stool. 3-5% of people in the community have these bacteria without having any signs or symptoms. C. difficile disease occurs when antibiotics kill your good bowel bacteria and allow the C. difficile to grow. When this bacteria grows, it produces toxins that can damage the bowel and may cause diarrhea.

Although our rates are low we strive for zero infections.

To control infections we:

• Promote hand washing among our staff and visitors
• Have enhanced environmental cleaning for patients with C. difficile infections.
• Use personal protective attire (gloves and gowns) for patients with infections
• Provide ongoing education of C. difficile to our employees, patients and their families.

C. difficile can be picked up on the hands from exposure in the environment, and can get into the stomach once the mouth is touched, or if food is handled and then swallowed. Once in the stomach, the bacteria usually will not cause any problems unless the other bowel bacteria are disturbed, which can happen when antibiotics are taken. Without the presence of the typical bowel bacteria, the C. difficile bacteria may start to grow and produce a toxin that will cause illness.

Certain people are at increased risk for acquiring C.difficile infection. These risk factors include:

• History of antibiotic usage
• Bowel surgery
• Chemotherapy
• Prolonged hospitalization
• Being elderly
• Serious underlying illness or debilitation

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.

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

When a person has C. difficile disease, the bacteria in the stool can contaminate surfaces such as toilets, handles, bedpans, or commode chairs. When touching these items our hands can become contaminated. If we then touch our mouth without washing our hands, we can become infected. Our soiled hands can also spread the bacteria to other surfaces. If you are in the hospital and have C. difficile diarrhea, to prevent the spread of the infection you will be put on precautions, which includes a single room until you are free from diarrhea for at least three days. Your activities outside the room may be restricted. All health care staff who enter your room wear a gown and gloves. Everyone MUST clean their hands when leaving your room.