CAUSE FOR CONCERN

A recent spike in C. difficile cases at The Ottawa Hospital could be an indication that the city’s medical system is overburdened.

The recent spike in C. difficile infections at The Ottawa Hospital could be a sign the city’s medical system is overburdened, says the city’s medical officer of health.

In an interview Friday, Dr. Isra Levy said the rise in C. difficile cases at the hospital is “disappointing,” but doesn’t pose a health risk to people in the broader community.

The increase is of concern, however, “because it’s kind of a sign that maybe our system is strained in terms of the number of patients that are flowing through,” he said. “It means that eternal vigilance is called for.”

Ottawa Hospital officials announced this week that C. difficile infection rates, which had been rising since last spring, jumped in December, with 27 new cases reported at the Civic and General campuses.

That produced an infection rate for the month of 0.94 per 1,000 patient days — more than double the hospital’s target.

For the year as a whole, the hospital expects a 0.6 rate — its highest since the Ontario government made public reporting mandatory in 2008.

C. difficile rates are posted monthly on Health Quality Ontario’s website, but the latest available are from November 2012. Locally, only The Ottawa Hospital has made its December infection rate public.

In November, the Montfort Hospital had the highest local infection rate at 0.85 per 1,000 patient days, representing six new cases.

The rate was 0.58 at the QueenswayCarleton, 0.38 at the Children’s Hospital of Eastern Ontario and 0.1 at St. Vincent Hospital. There were no C. difficile cases in November at other Ottawa hospitals.

C. difficile is an antibiotic-resistant “superbug” found in stool. It is spread in hospitals after patients or staff touch soiled surfaces such as toilets, handles and bedpans.

Most C. difficile disease is mild, but it can be severe in about 10 per cent of cases. About five per cent of people with C. difficile infections will die.

Levy said his office works closely with local hospital infection control officials, so “we were well aware of the issues facing The Ottawa Hospital.”

About a year ago, he said, local health officials began noticing that C. difficile cases at The Ottawa Hospital were increasing. “We were perplexed by that. The issue was trying to figure out what’s at the root of it, so we could move toward eliminating it.”

Levy has been impressed by the hospital’s response, most notably its decision to deploy rapid-response “SWAT teams” of clinical, housekeeping and infection control staff whenever new C. difficile infections are identified.

“The Ottawa Hospital is a very progressive organization,” he said. “It seeks to identify these problems early. My sense is The Ottawa Hospital is actually being proactive at looking at innovative approaches.”

Levy said public health officials aren’t seeing many C. difficile cases in long-term care institutions or retirement homes. Nor is there much evidence that the infection is circulating outside of institutions, though Ottawa Public Health doesn’t track community-acquired cases.

He said overuse of antibiotics has contributed to the spread of C. difficile, and urged residents not to demand the drugs if their doctors believe their illness is due to a virus. “Accept the recommendation that sometimes you just have to sit it out.”

To reduce the risk of spreading disease generally, people should be diligent about proper hygiene, especially handwashing, Levy said. They should also be “self-aware” of their own health and hygiene when visiting others, especially in hospital.