The definition of an “outbreak” was recently called into question, when a number of patients at St. Joseph’s Healthcare acquired c.difficile — but in a pattern which didn’t exactly match reporting guidelines.

This caused confusion within the hospital over whether to declare an outbreak situation, as well as highlighting the delay between an identified rise in infections, and when the public finds out about it.

Eventually, all outbreaks get reported in each hospital’s monthly filing on a public website set up by the Health Ministry. But it could be a month before the public hears about it, Baker acknowledges. Hundreds of patients and visitors could pass through a hospital in that time.

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One definition says an outbreak occurs when three or more new cases appear within seven days in one ward. It is also an outbreak when six or more cases occur within 30 days in a single ward or unit.

But at St. Joe’s, the current C. diff outbreak was not confined to one ward. Cases were spread through the hospital.  Chief of staff Dr. David Higgins says that made it difficult to establish whether St. Joe’s was in outbreak or simply faced a seasonal rise in C. diff.

“That’s why we agonized over this for several days,” says Higgins.

Full article: What makes it an oubreak?

Five seniors with C. difficile have died at St. Joseph’s Hospital in the last month.

That is nearly one in three of those who got the bacterial infection that causes severe diarrhea.
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C. diff is one of three outbreaks St. Joseph’s Healthcare is currently battling.

Another senior died during the first week of March from invasive Group A streptococcus, which was spreading on the geriatric psychiatry unit at the Centre for Mountain Health Services.

Three wards remain closed to visitors at the downtown hospital as St. Joseph’s tries to contain the Norwalk virus.

Full Article:  Three St. Joe’s patients die of C. diff since April 1

>>April 7th 2009

Feel safe in hospital?  You’re not.

“This trend toward green products is not without risk,” says Richard Marchand, a microbiologist and member of a government committee that monitors hygiene and safety standards in Quebec’s hospitals. He says that, since the industry escapes regulation, some products are diluted by the manufacturer and, once delivered to hospitals, diluted again by infection-control staff eager to save money – just as cheap beauty salons do with hair shampoo.”

>>April 2nd 2009

Hospitals cautioned against ‘green’ cleaners

“The flood of new “green” cleaning products and disinfectants being used by Canadian hospitals are often ineffective in combatting infections that sicken thousands of patients a year, experts warn.”

Infonaut will be in Chicago at HIMSS’09 from April 4th-8th.

We will be launching our Hospital Watch Live application, and CEO Niall Wallace will be participating in a roundtable on blogging.

Come and see us and partner ESRI in Booth 3648.

In a study funded by NIH, Harvard Medical School, and the Irish Health Research Board, researchers have found a method to accurately predict which patients will experience a recurrence of C.difficile infection:

The method correctly identified 77.3% of patients who had recurrent infection in a derivation cohort studied in 1998, according to Ciarán P. Kelly, M.D., of Harvard Medical School, and colleagues.

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C. difficile has become the leading cause of hospital-acquired infectious diarrhea. It affects millions of patients a year. Multiple recurrences are common, despite successful treatment of the initial episode

“This rule is valuable in clinical practice as it defines a high-risk population in whom awareness of the risk can facilitate more prompt recognition, diagnosis, and treatment of recurrent C. difficile,” Dr. Kelly said in a statement.

The rule combines three variables: age, disease severity, and antibiotic use.

Full article:  Clinical Rule Predicts C. Diff Recurrrence