C. difficile

The C. difficile infection rate is calculated as a rate per 1,000 patient days.

The “total patient days” represents the sum of the number of days during which services were provided to all inpatients during the given time period.

The rate is calculated as follows:

Number of new hospital acquired cases of C. difficile in Baycrest Hospital divided by total number of patient days (for one month) x 1000.

2015

 New nosocomial
cases of C. difficile
C. difficile rate per 1000 patient days
January 2015<50.27
February 201500
March 201500
April 2015<50.29
May 2015<50.41
June 2015<50.14
July 201500.00
August 2015<50.14

2014

 New nosocomial
cases of C. difficile
C. difficile rate per 1000 patient days
January 201400
February 201400
March 201400
April 201400
May 201400
June 2014<50.15
July 2014<50.14
August 201400
September 201400
October 201400
November 201400
December 2014<5<5

2013

 New nosocomial
cases of C. difficile
C. difficile rate per 1000 patient days
January 2013<50.40
February 2013<50.15
March 2013<50.14
April 2013<50.14
May 2013<50.13
June 201300
July 201300
August 201300
September 201300
October 201300
November 2013<50.14
December 201300

2012

 New nosocomial
cases of C. difficile
C. difficile rate per 1000 patient days
January 2012<50.14
February 2012<50.15
March 2012<50.26
April 2012<50.13
May 201200
June 2012<50.13
July 201200
August 2012<50.14
September 2012<50.41
October 2012<50.13
November 201200
December 201200

2011

 New nosocomial
cases of C. difficile
C. difficile rate per 1000 patient days
January 201110.13
February 201160.86
March 201130.4
April 201120.28
May 201110.13
June 201120.28
July 201150.66
August 201110.14
September 201110.14
October 201100
November 201100
December 201110.13

2010

 New nosocomial
cases of C. difficile
C. difficile rate per 1000 patient days
January 201010.13
February 201020.29
March 201010.13
April 201040.55
May 201000
June 201000
July 201030.39
August 201040.55
September 201040.55
October 201030.4
November 201020.3
December 201010.13

2009

 New nosocomial
cases of C. difficile
C. difficile rate per 1000 patient days
January 200970.94
February 200900
March 200910.13
April 200900
May 200940.54
June 200920.28
July 200930.41
August 200900
September 200930.41
October 200900
November 200960.82
December 200930.41

2008

 New nosocomial
cases of C. difficile
C. difficile rate per 1000 patient days
 New nosocomial
cases of C. difficile
C. difficile rate per 1000 patient days
August 200800
September 200830.41
October 200810.14
November 200810.14
December 200820.26

Frequently Asked Questions about C. difficile

What is C. difficile?

C. difficile is one of the many types of bacteria that can be found in the bowel, and has been a known cause of health care-associated diarrhea for about 30 years.


Where does C. difficile come from?

C. difficile is not new. Although people may associate it with health care settings, it doesn’t come from hospitals, long-term care homes or laboratories. It is found in the intestine, occurring naturally in 3-5% of adults (more commonly in the elderly) without causing symptoms.


What causes C. difficile?

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. The use of antibiotics increases the chances of developing C. difficile diarrhea as it alters the normal level of good bacteria found in the intestines and colon.

Without the presence of the normal bowel bacteria, the C. difficile bacteria may start to grow and produce a toxin that can damage the bowel and lead to watery diarrhea, fever and abdominal pain or tenderness.


How does C. Difficile spread?

When a person has C. difficile, the bacteria in their feces can contaminate surfaces such as toilets, bedpans, commode chairs, and door handles (if feces is on hands). Other healthy individuals can contaminate their hands if they touch these items. If these individuals then touch their mouths without washing their hands, they can become infected.

The spread of C. difficile occurs due to inadequate hand hygiene and environmental cleaning. C. difficile produces spores that survive for long periods and are resistant to destruction by many environmental factors (e.g. temperature, humidity).

Good hand hygiene is the single-most effective way to prevent the spread of infectious diseases like C. difficile.


What does hospital acquired infection mean?

Sometimes when patients are admitted to the hospital, they get infections while they are in the hospital. This is a hospital-acquired infection or a nosocomial infection, such as MRSA, VRE or C. difficile.


How is C. difficile treated?

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


For more information about C. difficile, please go to the following links:
Health Canada: C.Difificile Fact Sheet


Public reporting and rates

What reporting information is Baycrest providing?

On the last day of each month, beginning September 26, 2008, Baycrest, along with all of
Ontario’s hospitals, is required to publicly report on its website:

  • rates of new hospital-acquired C. difficile cases associated with the reporting facility,
  • separately for each hospital site; and
  • the number of new hospital-acquired C. difficile cases associated with the reporting facility.

The Ministry will also report the same information on its own website, at www.ontario.ca/patientsafety.


How are the rates calculated?

The C. difficile rate is calculated as follows:

Number of new hospital-acquired cases of C. difficile associated disease (CDAD) associated with the reporting facility x 1000 patient days divided by Number of patient days.

This rate represents the incidence rate of hospital-acquired CDAD associated with the reporting facility per 1000 patient days.

Rates will vary from month to month.


Where will I be able to access this information?

Baycrest’s website will show our rates of C. difficile and information relating to any new cases of C. difficile. You will also be able to access this information on the Ministry’s website at www.ontario.ca/patientsafety.


Baycrest specific information

How frequently will Baycrest report on C. difficile?

We will be reporting monthly, with new information posted on our site, and on the Ministry’s website, on the last day of every month.


What is Baycrest doing to help reduce the incidence of C. difficile?

Based on best practices, Baycrest has a comprehensive identification and management policy that ensures a standardized approach to C. difficile. This approach includes:

  • surveillance protocols – all staff are aware that any presence of diarrhea could be C.difficile
  • and they follow strict early identification protocols
  • extensive precautions;
    • intense environmental cleaning, which includes the use of a sporicidal disinfectant that kills C. difficile spores in ten minutes;
    • 48-hour, turn around time for C. difficile testing and treatment;
    • Contact precautions, which include handwashing, use of gloves, and personal protective gear.

Are the elderly more likely to get C.difficile than younger people?

No, being elderly is only one risk factor associated with C. difficile. Other risk factors include:

  • A history of antibiotic usage
  • Bowel surgery
  • Chemotherapy
  • Prolonged hospitalization
  • Serious underlying illness or debilitation

Do chronic and long-term care hospitals, like Baycrest, have higher rates of C.difficile?

Currently, there is very little data on the rates of C.difficile in chronic and long-term care. One of the purposes of public reporting is to help us understand trends regarding C.difficile.