Infection Prevention and Control (IPAC)

C. difficile is a bacteria found in soil and other natural environments. It can also live in your gut or bowel along with many other kinds of bacteria. C. difficile is one of the most common infections found in hospitals and long-term care facilities.

Antibiotics used to treat infections kill many of the good bowel bacteria and allow C. difficile to grow, causing irritation of the bowel and diarrhea. This can happen with antibiotics taken at home or while staying in the hospital. Symptoms can include watery diarrhea, fever, abdominal pain or tenderness. Blood may or may not be present in the stool.

Treatment depends on the severity of the illness. People with mild symptoms may not need treatment. For more severe disease, the doctor will order antibiotics.

Clostridium difficile spores persist for a long time in the environment. Transmission due to contaminated environmental sources and poor hand hygiene practices contribute to its spread within health care institutions. As a safety measure, staff will provide care using special precautions to prevent spread of the infection to other patients. The patient will be moved to a new room, and their activities outside their room will be restricted. Health care providers entering the affected patient’s room may wear a gown and gloves. Everyone must clean their hands when they enter and exit the room, including the patient and their visitors. Special cleaning and disinfection of the environment must be strictly followed.

C. difficile Infection Rates

Health-care-associated CDI rate per 1000 patient days

Fiscal 2024/2025	Queen Street Site
April 2024	0
May 2024	0

 

Fiscal	Queen Street Site	College Street Site
April 2016 to March 2017	0	0
April 2017 to March 2018	0	0
April 2018 to March 2019	0	0
April 2019 to March 2020	0	0
April 2020 to March 2021	0	0
April 2021 to March 2022	0	n/a
April 2022 to March 2023	0	n/a
April 2023 to March 2024	0	n/a

See Patient Safety Indicator Public Reporting at the Ministry of Health and Long Term Care.

Enterococcus is a bacteria that lives in the bowel and helps to digest food. These bacteria can sometimes cause infections. Vancomycin is an antibiotic that is used to treat some infections caused by enterococci. In some instances, enterococci have become resistant to this drug and thus are called vancomycin-resistant enterococci (VRE).

Some people carry VRE on their bodies, and it may never cause any problems or require any treatment. If an individual develops an infection with VRE, there are antibiotics available to treat the infection. People with VRE in the bowel and who have no signs and symptoms of an infection do not need to be treated. However, if there are signs and symptoms of an infection, the treatment may include many other antibiotics for a prolonged period of time. VRE causes infection when it is found outside of the bowel and in other body sites. Possible infections could be in blood, wound or urinary tract, like the bladder.

VRE is commonly spread by direct contact with an infected person, usually through the hands. It can also be spread through indirect contact with contaminated environmental surfaces or contaminated equipment.

Frequent hand hygiene helps prevent the spread of VRE. It is also important to clean patient rooms and equipment frequently and as needed.

VRE Bacteremia Infection Rates

Newly diagnosed health-care-associated VRE bacteremia (bloodstream infection)

Fiscal 2024/2025	Queen Street Site
Quarter One (April to June)	0
Quarter Two (July to September)
Quarter Three (October to December)
Quarter Four (January to March)

 

Fiscal	Queen Street Site	College Street Site
April 2016 to March 2017	0	0
April 2017 to March 2018	0	0
April 2018 to March 2019	0	0
April 2019 to March 2020	0	0
April 2020 to March 2021	0	N/A
April 2021 to March 2022	0	N/A
April 2022 to March 2023	0	N/A
April 2023 to March 2024	0	N/A

See reporting at the Ministry of Health and Long Term Care.

Hand hygiene is an integral part of patient safety. It is easy to do and is one of the most effective ways to prevent the spread of infection and illness in health care settings. Hand hygiene consists of washing your hands with soap and water or using an alcohol-based hand rub. Wash your hands after using the washroom, before eating and when your hands are visibly soiled. Use an alcohol-based hand rub to sanitize your hands before visiting a health care facility as well as before and after contact with a patient or their environment.

CAMH Infection Prevention and Control (IPAC) department provides hand hygiene education and training for the majority of staff and patients. IPAC has launched the Ministry of Health and Long-Term Care's "Just Clean Your Hands" program. For more information, visit Just Clean Your Hands.

MOHLTC Hand Hygiene Observations

All hospitals in Ontario are mandated by the Ministry of Health and Long-Term Care to start collecting hand hygiene data based on the “Four Moments for Hand Hygiene” as part of Ontario’s Just Clean Your Hands program. Hospitals are required to report on 200 observations annually for every 100 patient beds. CAMH is meeting these requirements.

Hand Hygiene compliance rates are reported annually and calculated based on compliance to the four moments of hand hygiene:

1. before initial patient/patient environment contact
2. before aseptic procedure
3. after body fluid exposure risk
4. after patient/patient environment contact.

Hand Hygiene Compliance

	2014-2015	2015-2016	2016-2017	2017-2018	2018-2019	2019-2020
Queen St. Site (M1)	82.5%	90.8%	77.3%	88.9%	82.3%	88.6%
Queen St. Site (M4)	88.3%	90.0%	88.0%	88.5%	88.0%	90.6%
College St. Site (M1)	88.9%	78.3%	77.3%	68.8%	81.3%	80.0%
College St. Site (M4)	88.0%	87.8%	85.3%	87.4%	90.0%	93.5%

 

Staff Hand Hygiene Compliance Rates – Annual 2020-2021

QS
BEF-PAT/ENV- 96.97%
AFT-PAT/ENV- 92.54%

CS
N/A

Staff Hand Hygiene Compliance Rates – Annual 2021-2022

CAMH/QS
BEF-PAT/ENV 80.2% - 142/177
BEF-ASP 95.2% - 20/21
AFT-BFL 91.2% - 83/91
AFT-PAT/ENV 78.2% - 330/422

Staff Hand Hygiene Compliance Rates – Annual 2022-2023

CAMH/QS
BEF-PAT/ENV 60.1% -175/291
BEF-ASP 82.4% -14/17
AFT-BFL 96.2% -76/79
AFT-PAT/ENV 72.8% -448/615

Staphylococcus aureus (Staph) is a type of bacteria that is commonly found on the skin and mucus membranes of healthy people. Some Staph bacteria are easily treatable, while others are not. Staph bacteria that are resistant to the antibiotic methicillin are known as Methicillin-resistant Staphylococcus aureus or MRSA. If left untreated, MRSA infections may develop into serious, life-threatening complications, such as infection of the bloodstream, bones and/or lungs (e.g., pneumonia).

There are no specific symptoms of MRSA because it can be normal nose or skin bacteria. Early diagnosis ensures that appropriate measures can be taken to limit the spread of the infection.

MRSA is usually spread through direct physical contact or through contact with objects contaminated with infected bodily fluids. Those with weakened immune systems and chronic illnesses are more susceptible to the infection and MRSA has been shown to spread easily in healthcare settings.

In order to prevent these infections, it is important to practice good hygiene to keep hands clean. Ensure cuts and scrapes are kept clean and covered until they have healed. It is also important to avoid unprotected contact with other people's wounds or bandages. Finally, do not share personal items such as towels or razors.

MRSA Bacteremia Infection Rates

MRSA bacteremia rate per 1000 patient days

Fiscal 2023/2024	Queen Street Site
Quarter One (April to June)	0
Quarter Two (July to September)	0
Quarter Three (October to December)	0
Quarter Four (January to March)	N/A

 

Fiscal	Queen Street Site	College Street Site
April 2016 to March 2017	0	0
April 2017 to March 2018	0	0
April 2018 to March 2019	0	0
April 2019 to March 2020	0	0
April 2020 to March 2021	0	N/A
April 2021 to March 2022	0	N/A
April 2022 to March 2023	0	N/A

See reporting at the Ministry of Health and Long Term Care.