C. difficile fight long way from over in Quebec hospitals

Quebec’s health care system is still struggling to contain clostridium difficile infections 10 years after an outbreak that killed more than a 1,000 patients in hospitals across the province.

Hundreds continue to die each year from the bacteria, better known as C. difficile. The latest figures from Quebec's public health research institute (INSPQ) are for the year 2010-2011, which saw 619 people die from C. difficile infections – the highest toll in the province since the 2003-2004 outbreak.

Much room for improvement

Stephane E. Roy says not enough is being done to improve the track record of Quebec hospitals on C. difficile.

Roy’s 59-year-old mother died after being infected with C.difficile in 2004. She was in hospital for heart surgery when she contracted the virulent mutation of the bacteria now known as the “Quebec strain.”

The actor is now working to raise awareness about the continuing dangers of C. difficile through an online video and petition.

“Sometimes people go into hospital for nothing serious, and never leave. And what is the government doing? They’re not talking about it - because C.difficile is the shame of our hospitals, a failure in our health system that we want to hide,” Roy says in the video.

A Montreal role model

The Montreal Heart Institute is playing a leading role in the fight to control C. difficile.

Strict preventive measures have seen the institute reduce cases of C. difficile originating in the hospital to zero for the last two years.

Overall, the Heart Institute's rate of hospital-acquired infection of 1.6 per cent is four times lower than the 6 to 8 per cent nosocomial infection rate typical of other North American hospitals with a similar mission.

“It’s been a tremendous fight to achieve that,” says Dr. Richard Marchand, a microbiologist and infectious disease specialist at the Heart Institute. “It’s a multifaceted fight. You can’t go to war with only one weapon.”

Among the measures adopted by the Montreal Heart Institute is the creation of a dedicated disinfection team. It also screens every new patient entering the hospital for infection and isolates those testing positive in special rooms.

Hospital housekeeping key

Dr. Marchand says budget cuts are the key impediment in the fight against C. difficile in Quebec's hospitals.

“What is cut first when we’re ordered to cut, say, half a million in an institution? Generally, it’s maintenance, it’s hygiene,” he says.

Dr. Marchand says it is also imperative that the province be more transparent with the public about the risks of C. difficile. He points to the United States government, which now requires hospitals to post their infection rates online.

“This has been the most efficient way to sensitize the population, and it would have the same impact here, both on the public and the government,” he says.