Study shows where C. difficile is hiding in hospitals

By Carrie Stefanson

There are no dog days of summer for Angus and Dodger, the canine scent-detection superstars at Vancouver Coastal Health (VCH). The two super sniffers were recently reviewed by a world-renowned scent detection expert – and passed their odour-recognition tests with flying colours.

The exemplary work of Angus, Dodger and the C. difficile Canine Scent Detection Program at VCH is highlighted in the summer 2019 edition of the Canadian Journal of Infection Control.

“Angus and Dodger’s special talents have a tremendous impact on people’s lives by helping prevent the spread and infection of C. difficile,” says Adrian Dix, Minister of Health. “On behalf of all British Columbians who benefit from their keen sense of smell and specialty training, we are grateful for this innovative approach to protecting patients and families.”

A new study shows between May 1, 2017 and October 31, 2018 Angus and Dodger, along with their K-9 handlers Teresa Zurberg and Jaime Knowles, searched 659 clinical areas at Vancouver General Hospital.

With their noses to the ground, the teams “alerted” on C. difficile bacteria 391 times. An alert occurs when the dogs smell C.difficile and alert their handlers. The teams did not search occupied patient rooms.

In 82 per cent of the cases, the dogs alerted in general areas of the hospitals including:

-Washrooms (public, patient and staff)

-Hallways

-Waiting rooms

-Staff lockers and lounges

-On equipment carts

“The canine team alerts have confronted our presumptions of where C. difficile reservoirs lie and challenged us to re-examine the way we approach infection prevention,” says Dr. Elizabeth Bryce, Director of Infection Control, Vancouver Coastal Health.

For example, the inside of a toilet-paper dispenser tested positive for C. difficile. Changing the design of the dispenser or the paper itself could reduce cross-contamination. The dogs also alerted on the tube system used to transport patient specimens. VCH purchased cleanable landing mats and reviewed the protocol for cleaning the tubes.

“Every positive alert is a teaching moment,” says Teresa Zurberg, Angus’ handler. “We work with Infection Control Practitioners to identity how C. difficile is spreading and address cleaning and disinfection practices. C.difficile is invisible and invasive, so even the most stringent cleaning might miss it.”

When Angus or Dodger alert on an item, the area is thoroughly cleaned. A fleet of rapid disinfecting robots (aka R-D) augment the cleaning process by delivering bursts of intense U-V light that eradicate antibiotic-resistant pathogens including C. difficile.

Angus and Dodger are English springer spaniels trained and certified to detect Clostridium difficile or C. difficile, a superbug that attacks people whose immune systems are weakened by antibiotics. They are part of an infection prevention team that includes an Infection Control Practitioner and housekeeping staff, all dedicated to reducing environmental contamination of C. difficile. This results in a reduction in the transmission of C. difficile by healthcare workers, visitors and patients, and, in turn, a decrease in the C. difficile infection rate.

While it is difficult to prove that scent detection alone reduces the spread of C. difficile, the highly visible presence of the dogs and handlers improves compliance with infection prevention measures such as hand hygiene, disinfection of personal items, and appropriate use of personal protective equipment.

Since its inception in 2016, the canine scent detection teams at VCH have successfully searched hundreds of hospital areas for C. difficile. They’ve also visited 30 Canadian health care facilities to share

Carrie Stefanson is Public Affairs Leader,  Vancouver Coastal Health.