Website reports cases of C. difficile in Ont. hospitals

Ontario hospitals had 319 cases of C. difficile last month, the province's first hospital-generated report on the infections showed Friday.

All 228 hospitals in Ontario are now required to publicly report the number of cases of C. difficile on a website that was launched Friday.

C. difficile bacteria may attack the intestines, and some strains produce toxins that can cause severe diarrhea and death from dehydration. It is usually picked up in hospitals and can flourish when a patient takes certain antibiotics or is recovering from bowel surgery.

More than 460 patients have died of C. difficile at 22 hospitals in Ontario in the past two years.

The 319 cases of C. difficile in August worked out to a rate of 0.39 cases per 1,000 patient days, lower than the rates reported in Quebec and the United Kingdom, Ontario's Health Ministry said.

"It is part of our government's plan to create an unprecedented level of transparency in Ontario's hospitals," Health Minister David Caplan said in announcing the website.

So far, the website does not list the number of deaths because health officials are trying to find an accurate way to count and sort cases where multiple underlying illness were found.

Until now, hospitals have gathered and monitored these numbers to get a jump on controlling outbreaks. The website is an accountability measure that allows people to compare hospitals in an area. 

Fran Merchant is struggling with her confidence in the health-care system. Her father, Jack Elliott, went into hospital last November for a knee operation as an otherwise healthy man. He died a month later infected with C. difficile.

 "They should have had the reporting in place," Merchant said. "I think it definitely would have helped. At least it would have alerted the public to these outbreaks. And if my dad had known, he would have rescheduled."

Limits to hospital comparisons

Since the number of cases a hospital has depends on how large it is, what type of patients are admitted and how well the hospital controls it, the website doesn't give a sense of "good" or "bad" hospitals, cautioned Dr. Alison McGeer, a microbiologist and director of  infection control at Toronto's Mount Sinai Hospital.

The data is important because it allows hospital and ministry officials to look for increases in numbers to gain a better understanding of what is happening, McGeer said. As new infections arise, it's hoped that having these mechanisms in place will help health officials to identify problems sooner and respond faster.

By the end of this year, hospitals will also be required to post rates of two so-called superbugs — Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin-resistant Enterococci (VRE).

At the release of the report, Caplan announced Ontario would also create an infection control resource team of medical professionals that can be sent to hospitals with an outbreak. 

Caplan also announced the hiring of 66 more infection control practitioners for hospitals and public health units.

Ontario is the second province to start posting infection rates for C. difficile. Quebec was the first.