Between April 1, 2013 and March 31, 2014, 5,251 cases of C. difficile-associated diarrhea (CDAD) were reported in more than 95 Quebec facilities (hospitals and health clinics), according to a study published by the Institut national de santé publique du Québec. The study also found that more cases were observed in facilities in which more than 35% of the clientele were aged 65 and older. This data excludes university facilities such as research, acute care and training centres, which have higher incidences than other centres, regardless of the average age. This can be explained by a number of factors, such as the complexity of the cases they handle—often patients with below-average immune systems. It should be noted that this rate is lower than the results of the five previous years, but still remains high at 8.7 cases per 10,000 patient days.
Meanwhile, non-university facilities with more than 100 beds and in which 35% of the clientele is aged 65 and older saw their reported cases of CDAD increase compared to previous years. Cases were also observed in rehabilitation and pediatric units. However, their incidence rates were lower than for other facilities.
If we compare the data from the year being studied with that from the previous year, the annual reported cases remained stable. Of the total number of reported cases, 70% were related to a current or previous hospitalization and 5% to outpatient care in the facilities studied. Of the 95 facilities, 11 experienced a significant increase in their incidence rate of nosocomial CDAD compared to the previous year.
It can be concluded that the bulk of infections are of an internal source. Disinfecting facilities with specialized products is essential for reducing the spread of infections such as C. difficile and CDAD.