C. difficile rates almost double at Ridge Meadows hospital

Infection rates still among the lowest in Fraser Health.

Infection rates for a highly contagious and antibiotic-resistant bacteria have almost doubled at Ridge Meadows Hospital this year over last, pushing it below the national benchmark for C. difficile.

However, the local hospital still maintains one of the lowest infection rates for the bacteria in Fraser Health.

C. difficile can cause diarrhea, abdominal pain, and flu-like symptoms. Patients taking antibiotics are especially susceptible, as antibiotics can wipe out competing intestinal bacteria that aid in digestion.

Ridge Meadows Hospital saw 17 cases of C. difficile in 2009/10, from April to March, and 25 for the same period in 2010/11.

This year, however, the hospital has already seen 42 cases of C. difficile infection, increasing the infection rate from 4.5 cases per 10,000 patient days last year to 8.7 in 2011/12.

Health Canada has a benchmark of 6.2 cases per 10,000 patient days for Canadian hospitals. Fraser Health hospitals have averaged an incidence rate of 12.7 so far this year.

Since 2009, there have been 16 deaths at Ridge Meadows Hospital by patients who had tested positive for C. difficile infection in the past year.

While C. difficile is rarely found as a primary cause of death, it can be a contributing factor, said Fraser Health spokesperson Roy Thorpe-Dorward.

Thorpe-Dorward said there a number of factors that can contribute to the spread of C. difficile.

The size and age of a hospital play a role, and with smaller, newer hospitals like Ridge Meadows, rates are typically lower, he said.

Patient demographics also play a role, as 80 per cent of sufferers are 70 and older.

“Older patients are certainly more susceptible,” said Thorpe-Dorward. “And where there’s careful control of antibiotic prescription, C. difficile rates are lower.”

One of the most important factors in C. difficile transmission is hand hygiene, he said.

A recent hand hygiene audit conducted by Fraser Health found that hospital staff at Ridge Meadows only sanitized their hands before and after patient interactions 42 per cent of the time.

Chilliwack General, which has the lowest incidence rate of C. difficile of all 13 Fraser Health hospitals, scored 92 per cent on the audit. Burnaby General Hospital, meanwhile, scored 36 per cent.

Last week, doctors at Burnaby general sent a letter to Fraser Health CEO Dr. Nigel Murray, stating C. difficile rates are so high and badly managed that it risks becoming the subject of legal action.

Debbie Picco, the B.C. Nurses Union’s Simon Fraser Region co-chair, said one of the main contributing factors has been the contracting out of housekeeping services to private contractors.

“Since [the province] privatized housekeeping services, any nurse will tell you the cleanliness of the hospitals has decreased a lot,” she said. “We find housekeepers aren’t available when they need to be, and they have improper education.”

Due to hospital understaffing, Picco said there is a lack of registered nurses to make assessments and ensure protocols are being followed.

However, Thorpe-Dorward says Fraser Health has maintained consistently high housekeeping standards. A recent housekeeping audit of Ridge Meadows Hospital by a third-party auditor resulted in the hospital receiving a score of 92 per cent.

Fraser Health has recently instituted more rigorous cleaning standards for emergency rooms, now requiring them to be cleaned with a sporadical cleanser twice daily.

The biggest thing the public can do when visiting the hospital to reduce C. difficile transmission is to rigorously wash their hands.

“Hand hygiene is critical to stopping the spread of C. difficile,” said Thorpe-Dorward.