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Hospital reporting of C. difficile decreases cases

Sometimes a bit of publicity can do wonders for resolving a seemingly intractable problem.

A decade ago, an alarming number of patients were picking up infections of Clostridium difficile while undergoing care in Ontario hospitals. The elderly and those receiving antibiotic treatment or cancer chemotherapy are extremely vulnerable to C. difficile, which causes diarrhea, fever, nausea and abdominal pain. In some cases, it can be fatal.

Then in September, 2008, the provincial Health Ministry announced that each hospital would have to publicly report the rate of C. difficile infections among patients.

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Mandatory disclosure turned out to an extremely effective means of bringing the infections under better control, according to a study by researchers at the Institute for Clinical Evaluative Sciences in Toronto.

The researchers reviewed Ontario data from 2002 to 2010. Their findings, published in the online journal PLoS Medicine, showed that hospital infection rates climbed from 2002 to 2008, reaching about 6,000 cases a year. But the introduction of public reporting in late 2008 was associated with a 26.7-per-cent plunge in infection rates, said the lead researcher, Nick Daneman, who is also an infectious disease specialist at the Sunnybrook Health Sciences Centre.

"We speculate that focusing the public lens on C. difficile helped to identify this pathogen as a major patient safety concern, and influenced hospitals to ramp up prevention efforts," Dr. Daneman said.

Over all, the researchers estimate that the infection control efforts have cut the number of C. difficile cases by almost 2,000 a year and resulted in 100 fewer deaths annually in Ontario.

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