title: Infection control practices related to Clostridium difficile infection in acute care hospitals in Canada.
abstract: BACKGROUND
  We carried out a survey to identify the infection prevention and control practices in place in Canadian hospitals participating in the Canadian Nosocomial Infection Surveillance Program (CNISP).
  
  
  METHODS
  An infection prevention and control practices survey was sent to CNISP hospitals at the beginning of November 2004, the same time that CNISP started a 6-month prospective surveillance for Clostridium difficile infection (CDI) to evaluate their infection prevention and control measures and laboratory methods for C difficile.
  
  
  RESULTS
  A total of 33 hospitals completed and returned the survey. Infection control precautions were initiated in 18 hospitals (55%) due to the presence of a symptomatic patient before the C difficile laboratory tests were available. All of the hospitals used gloves and gowns as additional precautions. Twenty-three hospitals (70%) tested liquid stools based on a clinician's order, and 8 (24%) tested all liquid stools submitted whether of not C difficile testing was requested. The hospitals used 1 of 3 different products as a standard hospital-wide disinfectant; 24 (73%) used a quaternary ammonium compound, 8 (24%) used accelerated hydrogen peroxide, and 1 (3%) used a hypochlorite solution (1:10 bleach solution).
  
  
  CONCLUSIONS
  Although the hospitals used contact precautions quite uniformly, considerable variation was seen among hospitals in terms of testing strategies, cleaning and disinfection protocols and products, and isolation practices. The timing for the initiation of infection control precautions is important to prevent secondary transmission of CDI. Most of the hospitals implemented precautions while waiting for the toxin assay results.
authors.affiliation: Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ontario, Canada. denise_gravel@phac-aspc.gc.ca
authors.forename: Denise
authors.initials: D
authors.lastname: Gravel
authors.forename: Michael
authors.initials: M
authors.lastname: Gardam
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Taylor
authors.forename: Mark
authors.initials: M
authors.lastname: Miller
authors.forename: Andrew
authors.initials: A
authors.lastname: Simor
authors.forename: Allison
authors.initials: A
authors.lastname: McGeer
authors.forename: James
authors.initials: J
authors.lastname: Hutchinson
authors.forename: Dorothy
authors.initials: D
authors.lastname: Moore
authors.forename: Sharon
authors.initials: S
authors.lastname: Kelly
authors.forename: Michael
authors.initials: M
authors.lastname: Mulvey
mesh_terms: D002170:Canada; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control* / Q000628:therapy*; D004761:Enterocolitis, Pseudomembranous / Q000382:microbiology / Q000517:prevention & control* / Q000628:therapy*; D006302:Health Services Research; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000706:statistics & numerical data*