Dear Colleagues:

Yesterday the Office of the Chief Coroner for Ontario released their preliminary findings on the C. Difficile outbreak experienced in Sault St. Marie's Sault Area Hospital (SAH). Throughout 2006 SAH experienced a high number of C. Difficile cases that prompted a corner inquest. In the Coroner's findings, C. Difficile was found to have either directly contributed to, or played a significant role, in the deaths of 18 SAH patients in 2006.

C. Difficile is an extremely hardy bacterium that affects elderly and immuno-suppressed individuals. Recently TWH experienced a C. Difficile outbreak on its medicine units closing 8A and B to new admissions. Due to our prompt response we quickly contained the outbreak and 8A has since reopened to new admissions. I would like to acknowledge everyone, particularly nursing, housekeeping, IPAC and volunteers, who worked around the clock to manage this outbreak and minimize the impact on patient care. Through creativity and flexibility we were able to maintain near normal volumes for medicine patients and ensure patients received exemplary care. It is due this teamwork that we have not had a new C. Difficile case for two weeks or new MRSA case for 3 weeks and we are hoping to resume normal operation on 8B in the not-too-distant future. In the mean time however, it's important to maintain contact precautions on 8B (gloves and gown) and be diligent in hand washing.

As we know, C. Difficile is present in all health care facilities across Canada and there are particular strains, such as those experienced at SAH, that are difficult to treat despite best efforts. UHN takes infection prevention and control extremely seriously and under the leadership of Dr. Michael Gardam with Occupational Health we have taken several measures to ensure that we are ahead of the curve with our infection control measures and we are responsive to issues should they arise.

Prevention is always the best approach in controlling the spread of disease. Washing your hands with either soap and water or alcohol hand rinse between contact with each and every patient is key to helping us prevent future outbreaks. To underscore the importance of proper hand hygiene UHN is implementing a hand-washing project to increase the rates of proper hand hygiene and is also part of a Ministry of Health hand-washing project. In the coming months you will see improved access to point of care alcohol hand rinse and education around proper hand hygiene. I encourage you to become involved in this project and join our quest in keeping our patients and staff safe.



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