5 year C. diff outbreak sees spike in cases at Canadian hospital, new infections

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The Ontario hospital where so many patients died after contracting a highly contagious infection may be poised to trigger a backup plan, as a recent spike in bacterial counts on the unit where the patients died raises concern about future infections.

Canadian health officials confirmed Thursday that four more Ontario residents have died since September due to the outbreak of Clostridium difficile (C. diff) infection that has so far infected 96 people. Three patients had contracted the potentially fatal infection while in an intensive care unit, the hospital and Public Health Ontario said. All four people were hospitalized at the Centre for Addiction and Mental Health in Toronto.

The outbreak at the Centre for Addiction and Mental Health also prompted the five-year anniversary of the deaths of Elizabeth Wettlaufer, 43, who died on October 12, 2012, and Adrian Lake, 37, who died on October 27, 2012. Wettlaufer had admitted to killing eight of her patients, citing in her case the ill-conceived belief that she could rid the wards of the C. diff bacteria.

“Our thoughts and prayers go out to all who have died and their families and loved ones,” Ontario Health Minister Christine Elliott said in a statement on Friday.

The province’s healthcare watchdog, the College of Physicians and Surgeons of Ontario, is investigating the cases as to whether any misdiagnosis or medical malpractice is to blame. The timeline of the outbreak is uncertain, as several patients were admitted before October 2015.

While infections of this bacterial strain can be fatal, the five-year outbreak at the Toronto facility has been comparatively mild compared to previous outbreaks. The current outbreak has seen an average of 1.6 new infections per day, compared to an average of 1.8 infections per day for the previous two outbreaks, according to Public Health Ontario.

Still, the department said the recent surge in C. diff cases is concerning and has already prompted staff to implement a plan of action to better equip staff.

“The superbug outbreaks are a wake-up call. We need to do everything we can to stop them from happening,” Elliott said.

In the meantime, the College of Physicians and Surgeons of Ontario is probing allegations of errors during the care of Wettlaufer, whose attempts to commit suicide in 2013 made headlines. The body has said it is also launching an inquiry into whether Wettlaufer’s case should be considered a criminal case.

Those responsible for preventing and treating patients in the event of an outbreak will face possible sanctions, according to their discipline committee. For instance, doctors could be held in contempt of court or be found responsible for intentionally covering up the infection, according to legislation.

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