Outbreaks have been declared at three of the seven hospitals operated by the Niagara Health System.

Ontario, CN Hospitals Battling C. Diff Outbreaks

The Globe and Mail reported at least 18 elderly patients have died, including 10 at a single hospital operated by the Niagara Health System.

Outbreaks of Clostridium difficile, or C. diff, a highly contagious, diarrhea-causing infection common in hospitals and long-term care facilities, are causing alarm among health and hospital professionals in and around Toronto, Canada.

Outbreaks have been declared at three of the seven hospitals operated by the Niagara Health System -- the three are St. Catherines General, Welland, and Greater Niagara General in Niagara Falls -- which is Ontario's largest multi-hospital organization and serves 434,000 residents in the region. On July 4, the system reported that a 10th patient had died that morning from the C. diff outbreak at St. Catherines, and 16 patients overall had died at the three hospitals with the outbreaks.

On July 5, in consultation with Guelph General Hospital, Dr. Nicola Mercer, Wellington Dufferin Guelph Medical Officer of Health, declared a C. diff outbreak at that hospital because seven cases were reported there in May alone and four more in June. GGH normally experiences one or two cases of hospital-acquired C. diff per month. "There are two scenarios when a C. difficile outbreak is declared," said Richard Ernst, the hospital's president and CEO. "One is to have a concentrated spike in the number of cases. The other is by having a longer two-month period of higher-than-usual activity." The number of cases began rising May 4, so July 4 marked the end of the two-month period of high activity and resulted in the outbreak being declared.

The hospital announced increased infection control measures that included hand hygiene audits, enhanced environmental cleaning, installing washable keyboards, providing disinfecting hand wipes to patients with their meals, and audited cleaning of patient rooms.

GGH asked visitors to clean their hands using a supplied alcohol gel when entering and leaving all areas of the hospital, while St. Catherines reduced visiting hours and asked visitors not to visit more than one patient room during any visit.

Eighteen elderly patients in all have died in the outbreak thus far, and about 200 people in Ontario die of C. diff. on average per year, the Toronto Globe and Mail reported July 7. People most at risk after exposure are typically older, with underlying illnesses, and are taking antibiotics. Overuse of antibiotics is considered to be one cause of the outbreaks in Canada and elsewhere.

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