C. Difficile
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C. Difficile
A chorus of concern about the management of a number of hospitals in Ontario's Niagara region is growing amidst an outbreak of Clostridium difficile that's been linked to the deaths of 16 patients.

The patients were being treated at three hospitals experiencing clusters of cases of the bacterial disease: four have died at the Greater Niagara General Hospital, 10 at St. Catharines General Hospital and two at the Welland Hospital since the outbreak was declared May 28.

The three centres are run by the Niagara Health System, a network of seven hospitals serving 434,000 people around Niagara Falls and St. Catharines.

Protesters will hold a rally outside the Greater Niagara General Hospital on Wednesday to voice their displeasure with the way the hospitals are being run.

Organizers said the outbreak of the disease, which causes severe diarrhea in certain vulnerable patients as a result of taking antibiotics, is just the latest example of how the network has mismanaged the hospitals.

"We believe the NHS has been ignoring the crisis in health care for a while and I think this particular issue, the C. difficile, was the thing that had our council say, 'We've had enough,'" said Niagara City Councillor Wayne Gates.

The Niagara Health System took too long to alert the public about the health concerns arising from C. difficile, Mr. Gates said, noting that health officials first learned about the outbreak May 12, but didn't alert the public until more than a month later.

This comes after the closing of emergency departments in two hospitals in the area.

"My priority is to keep us focused on the outbreaks, so not get distracted by the politics but make sure that we are focused internally on getting us out of the outbreak and keeping us from getting into any further outbreaks," said Sue Matthews, president and CEO of the Niagara Health System.

"That's our main area of focus."

The hospitals have taken a number of measures to prevent further spread of the bug, Dr. Matthews said. Those steps include restricting the number of visitors to the hospitals, hiring more cleaners and bringing in two infection-control teams.

The Niagara Public Health department is confident the network has responded in the appropriate manner, Dr. Matthews added.

Patients who regularly take antibiotics or have compromised immune systems - in many cases the elderly - can be particularly vulnerable to C. difficile, which is typically spread in hospitals through contact with bodily fluids.

Outbreaks of C. difficile can usually be avoided if staff recognize the signs early and take measures to prevent the bacteria from spreading, said infectious diseases expert Andrew Simor.

"When outbreaks occur, it's often because of a failure of infection-control measures or a failure in antibiotic utilization or some combination of both," said Dr. Simor, head of microbiology and infectious diseases at Sunnybrook Health Sciences Centre in Toronto.

Failure by health-care workers to wash their hands frequently enough, to place patients in isolation or to clean hospitals properly "could certainly contribute to the emergence and spread of such an outbreak," said Dr. Simor, adding that he doesn't know enough about the outbreak in the Niagara region to say whether that was indeed the case.

Dr. Matthews did not respond directly when asked what caused the outbreak, saying only that a level of C. difficile is present in most hospitals.

Liberal MPP Kim Craitor and Ontario NDP Leader Andrea Horwath will also attend Wednesday's rally.

"The C. difficile issue that has so tragically befallen the people of the Niagara Health System, the patients, is just the latest example of the fiasco that continues to roll in the Niagara Health System," said Ms. Horwath.

She wants an independent inquiry to examine how the Niagara Health System is being managed.

The Ontario government is monitoring the situation and is not directly involved in trying to contain the bug or trying to identify the reasons for the outbreak, said Andrew Morrison, spokesman for the Ministry of Health and Long-term Care.

"There could be a review down the road, it's difficult to say," Mr. Morrison said. "Today what we're most concerned with is just dealing with the outbreak as it's happening today."

Mr. Morrison added that the provincial government brought in new monitoring requirements more than two years ago, which includes a mandate that hospitals report all C. difficile cases.