In 1996, a survey of Canadian Hospital Epidemiology Committee (CHEC) sites showed variation in surveillance, prevention, detection and management of Clostridium difficile Infection (CDI). To better understand the burden of CDI and the impact of infection prevention and control measures, CHEC in collaboration with Canadian Nosocomial Infection Surveillance Program (CNISP) conducted a study to establish national prevalence rates of healthcare-associated CDI1.
In 2003, Quebec reported a multi-hospital outbreak of severe CDI with high morbidity and mortality in the Montreal region2. The outbreak was associated with a newer hypervirulent strain referred to as North American pulsed-field gel electrophoresis type 1 (NAP 1). Provincial surveillance for CDI in Quebec was mandated under Public Health Law in June 2004.
Shortly after the establishment of PICNet in May 2005, the PICNet Urgent/Emergent Issues Working Group (UEWG) determined the development of a standardized provincial surveillance protocol for CDI in BC acute care facilities to be a priority. In 2009, CDI became a nationally reportable disease through the Canadian Notifiable Disease Surveillance System.
| Date | Description | Communiques |
|---|---|---|
| 2005 - 2006 | PICNet Urgent/Emergent Issues Working Group (UEWG) prioritized a standardized surveillance protocol for Clostridium difficile associated disease (CDAD) in acute care (developed in June 2006). | Not applicable |
| Feb 2007 | PICNet establishes a new CDAD Surveillance Working Group | Not applicable |
| 2008 | All health authorities, Providence Health Care and PHSA sign a Participation Agreement outlining the roles and relationships of each health authority and PICNet, and the governance principles for the CDAD surveillance program. | Not applicable |
| 2009 | CDI became a notifiable disease under national surveillance through the Canadian Notifiable Disease Surveillance System. | Not applicable |
| Jan 2010 | PICNet, in collaboration with the health authorities, publishes its first provincial quarterly CDI report with historical data going back to 2006. | Not applicable |
| Feb 2013 | A provincial CDI Toolkit and Clinical Management Algorithm is published through collaboration with the BC Ministry of Health, PICNet and the health authorities. | 2013 CDI Toolkit |
| Mar 2013 | BC Ministry of Health issues health policy communique to health authorities advising of immediate implementation of standards for appropriate treatment and management of CDI cases and outbreaks and the adoption of provincial surveillance case definitions. | 2013 MOH Policy |
| Aug 2018 | The CDI Toolkit and Clinical Management Algorithm for Acute Care is updated. | 2018 CDI Toolkit |
- N-CDAD in Canada: Results of the Canadian Nosocomial Infection Surveillance Program 1997 N-CDAD Prevalence Surveillance Project (hindawi.com)
- A Predominantly Clonal Multi-Institutional Outbreak of Clostridium difficile–Associated Diarrhea with High Morbidity and Mortality | New England Journal of Medicine (nejm.org)