C. difficile outbreaks in Gatineau, Sault Ste. Marie

A virulent strain of Clostridium difficile that has killed close to 2000 people in Quebec spread to a Gatineau hospital this spring, hospital officials have confirmed.

There were 15 cases of this strain of C. difficile at the Santé Service Sociale de Gatineau's Hull hospital campus in April and May, says Denis Saint-Jean, the hospital's director of communications. As of July 5, 3 people remained ill with C. difficile.

“Through surveillance by our infection control team, we found out that the strain we have now is the same more strenuous strain that they have in Montréal,” Saint-Jean says.

Officially known as NPA1/027, the strain produces levels of 2 kinds of toxins that are 16–23 times more potent than the common strain of C. difficile (Annals of Surgery 2007;245:267-72).

“Just to be on the safe side, we now take all our sampling and send it to Montréal, so they can really identify that it's the same strain,” says Saint-Jean.

The hospital surmised that the strain was probably introduced into the institution through a patients transferred from Montréal. No one has died from the outbreak in Gatineau, which has now ended.

Dr. Michel Brazeau, head of professional services at the hospital, says the outbreak was handled appropriately and that staff were “very observant.”

According to October 2006 data from l'Institut de la statistique du Québec, C. difficile has been directly responsible for 1900 deaths in the province since 2002.

Earlier this year, the Office of the Chief Coroner of Ontario investigated 26 deaths at the Sault Area Hospital in Sault Ste. Marie, Ont. The investigation concluded that hospital-acquired C. difficile caused 10 of those deaths, contributed to the deaths of another 8 patients, but wasn't a factor in the final 8 cases.