Control of a nosocomial outbreak of severe C.difficile-associated diarrhea at the Centre Hospitalier Pierre-Le Gardeur: a case report.

Pierre-Jean Maziade MD¹, Doris Gagné RN¹, Gilles Murray MD¹, Christine Jacob RN¹, Pascale Pereira dt.p¹, Line Méthot, B.Pharma, M.Sc. adm².
 

¹ Service de prévention des infections et ²Département de pharmacie, Centre Hospitalier Pierre-Le Gardeur.
 

Short running title: Primary prevention of Clostridium difficile colitis with a probiotic.

Note: Centre hospitalier Pierre-Le Gardeur is the principal institution from which the study originates.

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Treatment-resistant microbial germs have become a major public health problem.

Microorganisms that are resistant to various forms of treatment cause most nosocomial infections. More and more, microbial germs are found not only in hospitals but also in the community at large among people who have had no contact with the clinical environment.

The World Health Organization (WHO) recommends the implementation of nine specific measures to improve patient safety.

After launching the "World Wide Challenge for Patient Safety" campaign in October 2005, WHO launched another major campaign in 2007 for the prevention of "medical accidents." Medical accidents are not complications of the original illness. To the contrary, they are caused by errors or deficiencies in medical treatment. Simply put, such accidents are easily avoidable "undesirable events." Nosocomial infections are medical accidents.

Preventative measures for C. difficile are essentially the same as for other nosocomial infections (NI's). C. difficile however, poses a particular problem because it generates spores that are resistant to several regular disinfectants. These spores can survive for weeks, even months in the hospital environment.

Three types of measures should be implemented:

• 1. General precautionary measures that apply to all patients regardless of whether they are C. difficile carriers.
• 2. Additional precautionary measures when infections occur.
• 3. Strict control of antibiotics for all patients regarding treatment.