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.”

4 newborns dead from hospital-acquired infection in N China

>>Mar 21

Four newborns died and two others were still receiving medical treatment after contracting infections in a hospital in north China’s Tianjin Municipality, local health official said Saturday.

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An initial investigation showed the deaths were caused by hospital-acquired infection of enterobacter cloacae, a clinically significant Gram-negative bacterium.

One of the two newborns receiving medical treatment did not survive.  Five hospital staff were fired over the deaths of the five newborns.

>>Mar 30

Five staff of China hospital dismissed over newborn children deaths

Wang Xin, president of Jixian County Maternal and Child Care Service Center in northern Tianjin Municipality, and Wang Lianjiang, the center’s vice president, were removed from their posts, the Jixian County government said.

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Three other staff in charge of newborn care service at the center were also dismissed from their posts.

The county government has decided to compensate each family of the dead newborn children with 180,000 yuan (26,354 U.S.dollars).

Canadian Medical Association Journal (CMAJ) has published “Hospital infection control strategies for antibiotic-resistant organisms”:

Identified risk factors include:

…increasing age of patient and severity of disease, increasing length of hospital stay, admission to an intensive care unit and proximity to patients carrying an antimicrobial-resistant organism. Use of broad-spectrum antibiotics and/or prolonged use of antibiotics are also risk factors.

Full Article:  “Hospital infection control strategies for antibiotic-resistant organisms”