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Canadian Journal of Infectious Diseases
Volume 12, Issue 2, Pages 81-88
Original Article

N-CDAD in Canada: Results of the Canadian Nosocomial Infection Surveillance Program 1997 N-CDAD Prevalence Surveillance Project

Meaghen Hyland,1 Marianna Ofner-Agostini,2 Mark Miller,3 Shirley Paton,2 Marie Gourdeau,4 Magued Ishak,5 the Canadian Hospital Epidemiology Committee, and the Canadian Nosocomial Infection Surveillance Program (Health Canada)

1University of Toronto, Department of Public Health Sciences, MHSc program in Community Health and Epidemiology, Toronto, Ontario, Canada
2Division of Nosocomial and Occupational Infections, Laboratory Centre for Disease Control, Ottawa, Ontario, Canada
3Jewish General Hospital, Montreal, Quebec, Canada
4Hôpital de LEnfant Jésus, Quebec, Quebec, Canada
5Hotel Dieu de St Jerome, St Jerome, Quebec, Canada

Received 26 October 1999; Accepted 1 June 2000

Copyright © 2001 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: A 1996 preproject survey among Canadian Hospital Epidemiology Committee (CHEC) sites revealed variations in the prevention, detection, management and surveillance of Clostridium difficile-associated diarrhea (CDAD). Facilities wanted to establish national rates of nosocomially acquired CDAD (N-CDAD) to understand the impact of control or prevention measures, and the burden of N-CDAD on health care resources. The CHEC, in collaboration with the Laboratory Centre for Disease Control (Health Canada) and under the Canadian Nosocomial Infection Surveillance Program, undertook a prevalence surveillance project among selected hospitals throughout Canada.

OBJECTIVE: To establish national prevalence rates of N-CDAD.

METHODS: For six weeks in 1997, selected CHEC sites tested all diarrheal stools from inpatients for either C difficile toxin or C difficile bacteria with evidence of toxin production. Questionnaires were completed for patients with positive stool assays who met the case definitions.

RESULTS: Nineteen health care facilities in eight provinces participated in the project. The overall prevalence of N-CDAD was 13.0% (95% CI 9.5% to 16.5%). The mean number of N-CDAD cases were 66.3 cases/100,000 patient days (95% CI