title: Infection prevention and control practices related to Clostridium difficile infection in Canadian acute and long-term care institutions.
abstract: BACKGROUND
  Clostridium difficile is an important pathogen in Canadian health care facilities, and infection prevention and control (IPC) practices are crucial to reducing C difficile infections (CDIs). We performed a cross-sectional study to identify CDI-related IPC practices in Canadian health care facilities.
  
  
  METHODS
  A survey assessing facility characteristics, CDI testing strategies, CDI contact precautions, and antimicrobial stewardship programs was sent to Canadian health care facilities in February 2005.
  
  
  RESULTS
  Responses were received from 943 (33%) facilities. Acute care facilities were more likely than long-term care (P < .001) and mixed care facilities (P = .03) to submit liquid stools from all patients for CDI testing. Physician orders were required before testing for CDI in 394 long-term care facilities (66%)-significantly higher than the proportions in acute care (41%; P < .001) and mixed care sites (49%; P < .001). A total of 841 sites (93%) had an infection control manual, 639 (76%) of which contained CDI-specific guidelines. Antimicrobial stewardship programs were reported by 40 (29%) acute care facilities; 19 (54%) of these sites reported full enforcement of the program.
  
  
  CONCLUSIONS
  Canadian health care facilities have widely varying C difficile IPC practices. Opportunities exist for facilities to take a more active role in IPC policy development and implementation, as well as antimicrobial stewardship.
authors: Canadian Field Epidemiology Program, Public Health Agency of Canada, Ottawa, ON, Canada.
authors: Krista
authors: K
authors: Wilkinson
authors: Denise
authors: D
authors: Gravel
authors: Geoffrey
authors: G
authors: Taylor
authors: Allison
authors: A
authors: McGeer
authors: Andrew
authors: A
authors: Simor
authors: Kathryn
authors: K
authors: Suh
authors: Dorothy
authors: D
authors: Moore
authors: Sharon
authors: S
authors: Kelly
authors: David
authors: D
authors: Boyd
authors: Michael
authors: M
authors: Mulvey
authors: Aboubakar
authors: A
authors: Mounchili
authors: Mark
authors: M
authors: Miller
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000592:standards; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008134:Long-Term Care
chemical_list: D000900:Anti-Bacterial Agents