High levels of C. difficile at Surrey Memorial
Surrey Memorial Hospital has recorded 269 cases of C. difficile infections so far this year – the most of any hospital in the Fraser Health region.
And its infection rate for the highly contagious antibiotic-resistant bacteria is also running well above both the regional average and national standard.
SMH has a C. difficile infection rate of 15.7 cases per 10,000 patient days so far in 2011-12. That's more than double Health Canada's benchmark of 6.2 cases per 10,000 patient days for Canadian hospitals as well as the average of 12.7 for Fraser Health hospitals so far this year.
Surrey's rate is up from 14 cases last year and isn't far behind the incident rate of 16.6 at Burnaby Hospital, where doctors recently spoke out, warning C. difficile rates are so high and badly managed the health region "has placed itself at significant risk of medical-legal action."
C. difficile infects the intestines and can cause illnesses ranging from diarrhea, nausea, vomiting, fever and colitis and in some cases, result in death.
A number of deaths across the health region have been linked to C. difficile infections in recent years.
Fraser Health said 13 patient deaths at Burnaby Hospital in 2010-11 occurred where C. difficile is believed to be a contributing factor, but eight patients were over age 80 and all had other complicating medical conditions.
While C. difficile is rarely found as a primary cause of death, it can be a contributing factor, said Fraser Health spokesperson Roy Thorpe-Dorward.
He said there a number of factors that can contribute to the spread of C. difficile.
The size and age of a hospital play a role, with lower rates typically seen at smaller, newer hospitals rates, he said.
Patient demographics also play a role – 80 per cent of sufferers are 70 and older.
“Older patients are certainly more susceptible,” Thorpe-Dorward said. “And where there’s careful control of antibiotic prescription, C. difficile rates are lower.”
Antibiotics often kill good bowel bacteria and allow C. difficile to grow.
An independent review of infection control at Burnaby Hospital recently found the high rates at Fraser pose serious challenges and it will take a determined effort to reduce them.
Fraser Health CEO Dr. Nigel Murray said the region is implementing all 13 recommendations from an independent review of hospital infection-control practices.
A senior medical director for Fraser Health will also be hired to be in charge of efforts to reduce the infection rates across the region.
Debbie Picco, the B.C. Nurses Union’s Simon Fraser Region co-chair, said one of the main contributing factors has been the contracting out of housekeeping services to private contractors.
“Since [the province] privatized housekeeping services, any nurse will tell you the cleanliness of the hospitals has decreased a lot,” she said. “We find housekeepers aren’t available when they need to be, and they have improper education.”
Due to hospital understaffing, Picco said there is a lack of registered nurses to make assessments and ensure protocols are being followed.
However, Thorpe-Dorward says third-party audits have shown Fraser Health has maintained consistently high housekeeping standards.
Fraser Health has recently instituted more rigorous cleaning standards for emergency rooms, now requiring them to be cleaned with a sporadical cleanser twice daily.
The biggest thing the public can do when visiting the hospital to reduce C. difficile transmission is to take advantage of the many hand sanitizing stations.
“Hand hygiene is critical to stopping the spread of C. difficile,” Thorpe-Dorward said.
– with files from Robert Mangelsdorf