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Source: http://www.canada.com/nanaimodailynews/news/story.html?id=b9928e5d-62d4-4a34-be0e-3e0917a45afd
Deaths of C. diff-infected patients under investigation
Derek Spalding, Daily News
Published: Wednesday, October 22, 2008
Several more patients with Clostridium difficile died at Nanaimo Regional General Hospital recently, but doctors have not identified if the virulent disease caused their deaths.
Health officials claim to have controlled the outbreak even with the number of infected patients rising to 73.
The Vancouver Island Health Authority declared the outbreak in July after identifying a sharp increase of infected patients. Incidents of C. difficile affected 16 patients in July, up from eight in June and three in both April and May.
Three patients died from the disease since April, but Dr. David Forrest said he still has to review patient charts in order to determine the cause of the most recent deaths.
He also did not know the exact number of new deaths, indicating that "several" is the best count he could provide.
C. difficile was described as a painful disease that can colonize in a person's bowel and produce a toxin if he or she has been on antibiotics. Symptoms can get "nasty" before death, according to Bonnie Henry, infection control specialist at the B.C. Centre for Disease Control, who spoke to the Daily News in August. In severe cases, patients may require surgery to remove the large bowel, an operation doctors performed on the third person to die during the outbreak at NRGH.
The number of cases continued to escalate throughout August, but the rate plateaued in September, according to Forrest, the lead on VIHA's infection control team.
Eleven people still have C. difficile. Nine more patients were identified in the past six weeks, up from the 64 reported as of Sept. 5. In order to remove the outbreak designation, NRGH must restrict the number of new infections to about two or three during a four-week period. Cases will continue to trickle in, according to Forrest, who said the disease is not an easy one to quickly remove.
"The number of incidents increased quite rapidly over July and August, that was the upswing," he explained. "I anticipate this is the down swing, which will tail off much more slowly. It peaked in eight weeks, I expect it to take longer to declare the outbreak over." Preliminary results have come back from the centre for disease control about the type of strain, but more testing is necessary to determine whether or not the current spread of C. difficile is dominated by the aggressive strain that has killed 1,400 people in Quebec since 2003. Forrest said in August he was certain that NRGH had the Nap 1 strain that tends to be resistant to certain antibiotics used to treat the disease.
Determining how the disease could have spread so quickly in the hospital will take a few more weeks, he said yesterday.
Earlier reports from VIHA indicated that a variety of items could have led to the spread, including housekeeping, the use of infection control precautions and antibiotics. Both housekeeping staff and the B.C. Nurses Union has also spoken out about overworked employees that could have contributed.
DSpalding@nanaimodailynews.com
250-729-4231
Deaths of C. diff-infected patients under investigation
Derek Spalding, Daily News
Published: Wednesday, October 22, 2008
Several more patients with Clostridium difficile died at Nanaimo Regional General Hospital recently, but doctors have not identified if the virulent disease caused their deaths.
Health officials claim to have controlled the outbreak even with the number of infected patients rising to 73.
The Vancouver Island Health Authority declared the outbreak in July after identifying a sharp increase of infected patients. Incidents of C. difficile affected 16 patients in July, up from eight in June and three in both April and May.
Three patients died from the disease since April, but Dr. David Forrest said he still has to review patient charts in order to determine the cause of the most recent deaths.
He also did not know the exact number of new deaths, indicating that "several" is the best count he could provide.
C. difficile was described as a painful disease that can colonize in a person's bowel and produce a toxin if he or she has been on antibiotics. Symptoms can get "nasty" before death, according to Bonnie Henry, infection control specialist at the B.C. Centre for Disease Control, who spoke to the Daily News in August. In severe cases, patients may require surgery to remove the large bowel, an operation doctors performed on the third person to die during the outbreak at NRGH.
The number of cases continued to escalate throughout August, but the rate plateaued in September, according to Forrest, the lead on VIHA's infection control team.
Eleven people still have C. difficile. Nine more patients were identified in the past six weeks, up from the 64 reported as of Sept. 5. In order to remove the outbreak designation, NRGH must restrict the number of new infections to about two or three during a four-week period. Cases will continue to trickle in, according to Forrest, who said the disease is not an easy one to quickly remove.
"The number of incidents increased quite rapidly over July and August, that was the upswing," he explained. "I anticipate this is the down swing, which will tail off much more slowly. It peaked in eight weeks, I expect it to take longer to declare the outbreak over." Preliminary results have come back from the centre for disease control about the type of strain, but more testing is necessary to determine whether or not the current spread of C. difficile is dominated by the aggressive strain that has killed 1,400 people in Quebec since 2003. Forrest said in August he was certain that NRGH had the Nap 1 strain that tends to be resistant to certain antibiotics used to treat the disease.
Determining how the disease could have spread so quickly in the hospital will take a few more weeks, he said yesterday.
Earlier reports from VIHA indicated that a variety of items could have led to the spread, including housekeeping, the use of infection control precautions and antibiotics. Both housekeeping staff and the B.C. Nurses Union has also spoken out about overworked employees that could have contributed.
DSpalding@nanaimodailynews.com
250-729-4231
