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C. difficile outbreak kills 9 in Saint-Hyacinthe

Last Updated: Friday, October 27, 2006 | 12:35 PM ET

Nine people have died and 13 others are ill after an outbreak of C. difficile at a Saint-Hyacinthe hospital, and officials believe it may be a more virulent and resistant strain of the bacterium.

The Centre hospitalier Honoré-Mercier, east of Montreal, has started a decontamination and sterilization blitz after tracking the 22 cases over a three-month period that started July 23.

Denis Blanchard, director of the Centre de santé et des services sociaux Richelieu-Yamaska, says a massive sterilization blitz is underway.Denis Blanchard, director of the Centre de santé et des services sociaux Richelieu-Yamaska, says a massive sterilization blitz is underway.
(Radio-Canada)

The hospital's five regular units have already been disinfected, and the emergency room and intensive-care unit are next, confirmed Denis Blanchard, director of the Centre de santé et des services sociaux Richelieu-Yamaska.

More than 50 per cent of the facilities will be thoroughly decontaminated, he said.

The hospital has also posted signs reminding people to wash their hands, and has restricted access for children 12 and under. Visiting hours are scaled back and just one person is allowed to see patients at a time.

The outbreak affected elderly patients, officials said. They believe the outbreak is limited to the hospital, and is under control.

Blanchard says prophylactic measures to combat C. difficile did help limit its spread in this particular case, although he qualified the outbreak as "dramatic."

Antibiotic link

C. difficile, which causes severe diarrhea, has been traditionally thought of as an infection acquired in hospitals, where antibiotic use is rife. Antibiotics are known to upset the bacterial balance of the human gut, which can allow C. difficile to take root and flourish.

The Quebec hospital's outbreak may have been caused by a different C. difficile strain that could be more virulent than others documented in the province, Blanchard told Radio-Canada Friday. 

The infection was probably introduced to the hospital by an ER patient, he adds.

Several Quebec hospitals experienced C. difficile outbreaks in 2004, but the bacterium was believed to be contained following stringent sanitary measures.

The 2004 outbreak hit hospitals in Montreal, the Eastern Townships, Montérégie, Lanaudière and l'Abitibi, with more than 7,000 people reporting infections at the time.

At least 600 of them died following infection, according to research done by Dr. Vivian Loo at the McGill University Health Centre.

No comparison with last outbreak

The Saint-Hyacinthe outbreak comes at a point when C. difficile is no longer considered a major problem in Quebec hospitals, even though it is a constant threat, said Dr. Karl Weiss, an infectious disease expert at Montreal's Maisonneuve-Rosemont Hospital.

"There's absolutely no comparison between what we're going through now, and what we went through a few years ago.

"However, we're not going to eradicate the bacteria completely. There will always be a few cases of C. difficile," he told CBC on Friday.

The outbreak at the Centre hospitalier Honoré-Mercier in Saint-Hyacinthe came just as the hospital was returning to normal after a major mould infestation that forced administrators to renovate the medical centre.

Hospital administrators insisted the outbreak has nothing to do with the mould problem.

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