Test for C. difficile before discharge: patient

A man who contracted C. difficile at Victoria General Hospital in Halifax thinks his case could have been handled better.

Daniel MacDougall, from Little Judique in Cape Breton, went to Victoria General for stomach surgery six weeks ago.

MacDougall said he was at high risk to get C. difficile because he was on antibiotics. He also had the main symptom — diarrhea.

MacDougall said he should have been tested before he was discharged.

"Actually I didn't find out I had it until I came back from Inverness. When I left Halifax I still had the diarrhea. I had the diarrhea from day one after the surgery while I was 12 to 14 days in Halifax and then after I got home. every day it just kept on getting worse and worse. I kept losing strength, losing weight so I finally had to give in and go back to Inverness to the hospital," explained MacDougall.

MacDougall believes he contracted C. difficile because the hospital wasn't cleaned properly.

"Well, I found the floors very dirty in there. The washroom was not very clean. The period I was in there was three or four days, they never even took the garbage out of the washrooms," said MacDougall.

The Capital District Health Authority maintains its cleaning is inspected regularly.

Dr. Des Leddin is a gastroenterologist. He said he has no knowledge of MacDougall's case but when patients have diarrhea for a long time C. difficile should be suspected. However, he admits every case is different.

"Sometimes people have very minor symptoms at the beginning and perhaps it is assumed that this is just a non-specific, antibiotic-related, diarrheal illness and not C. diff. I can imagine circumstances in which it is not tested for as well," said Leddin.

MacDougall thinks anyone in hospital with diarrhea should be tested for C. difficile.

Several Cape Breton hospitals are struggling with a virulent strain of the bacteria. C. difficile has been implicated in the deaths of four patients in the Cape Breton District Health Authority. 21 patients are being treated after testing positive for the highly resistant bacteria, but there have been no new cases in the last two or three days.

None of Nova Scotia's other health districts have had any deaths from C. difficile. Most have had between one and five cases so far this year.

Only Capital Health and Annapolis can say they do not have the potentially lethal strain that's causing deaths in Cape Breton because they test for NAP1. Nova Scotia's other health districts don't test for the strain.

Last year, Capital District Health Authority saw 81 cases of C. difficile, down from previous years. The district's numbers have dropped every year since 2004 when they peaked at 211.

Because patients on antibiotics are more susceptible, the Pictou District Health Authority has started a new program where it's being very careful with how antibiotics are prescribed in its institutions, trying to keep them to a minimum. In most districts, measures like hand washing, isolating infected patients and thorough cleaning, especially bathrooms, is the usual deterrent.