Washing Hands - H1N1 measures curb C. difficile infections

The fight against the swine flu seems to be having another positive effect in Quebec hospitals — combating the deadly C. difficile bacteria, Dr. Alain Poirier, the province’s chief public health officer, said Friday.

Last month, Quebec hospitals registered their lowest rate of infections from C. difficile in five years. And the swine flu pandemic may be partially responsible, Poirier said.

In October, there were 4.3 infections for every 10,000 patients in hospital — the lowest level since the province began closely tracking the C. difficile bacteria five years ago, Poirier said.

A major change in hospitals between then and now is that visitors and patients are constantly being reminded to wash their hands because of the H1N1 virus.

"Generally speaking, all the population has now understood that washing your hands is good for influenza," Poirier said. "But it's also good for a lot of other diseases transmitted by contamination of your hands."

Quebec began tracking C. difficile after a deadly epidemic in 2003, when most of the victims were elderly patients already in hospital. The bacterial spores are very difficult to clean off or kill.

C. difficile outbreak declared in Canada

There is another outbreak of the Clostridium difficile bacterial infection at Nanaimo Regional General Hospital.  Six months ago, the Vancouver Island Health Authority confirmed an end to an earlier C. difficile outbreak that began in July 2008. That outbreak affected nearly 100 patients and was directly responsible for five deaths.

Dr. Martin Wale, medical director for infection prevention and control, said C. difficile cases are again higher than expected at the Nanaimo hospital.

From mid-October to mid-November, NRGH saw 11 cases of C. difficile, well above the expected average of five patients with C. difficile at any one time.  As of Tuesday, Wale said there are seven patients in isolation at NRGH with the infection, adding that two patients acquired the infection from the community.  The health authority’s outbreak protocol requires enhanced cleaning, including a top-to-bottom cleaning of the entire hospital and more powerful cleaning chemicals.