Clostridium difficile (C. difficile) is the most common cause of acute diarrhea in hospitals and long-term care facilities in North America. Over 60% of C. difficile cases are acquired within healthcare facilities. Reducing environmental contamination plays a key role in preventing the spread of infection to immunocompromised patients and healthcare workers.
C. difficile is extremely resilient, and, depending on conditions, can persist in the open environment for several months – spores are resistant to common routine cleaning agents and hand sanitizers, and have been shown to travel by physical means, making them very difficult to eliminate. Special chemical disinfectants & protocols are required to eradicate C. difficile, but the challenge lies in knowing where the contamination exists in order to take necessary steps to keep our healthcare facilities safe.
A multi-disciplinary team at Vancouver General Hospital has developed a program that trains dogs to detect C. difficile with high accuracy. Since its inception in 2016, our canine detection teams have successfully searched hundreds of hospital areas for C. difficile. Each contamination alert is acted upon immediately and used as an opportunity for in-the-moment education for healthcare workers, cleaning staff and patients. Alert data is also used to design & implement targeted quality improvement initiatives.
Enhance surveillance measures - a cost-effective method to rapidly detect & monitor contamination
Increase staff engagement - provide feedback & education based on real-time alerts
Improve practices - highlight & address gaps in cleaning & infection control practices
Reduce environmental contamination - decrease transmission risk to patients & health care workers
Angus is an English springer spaniel trained to detect Clostridium difficile (CDI or C. difficile) in the environment. He has superb scent abilities.
Teresa Zurberg is a nationally recognized K-9 handler. Teresa acquired C. difficile in the past. Her illness sparked her husband a nurse, to approach Vancouver Coastal Health with the idea of training a dog to detect C. difficile.
Dodger is a Springer Spaniel, like Angus. He is now accustomed to the hospital setting and trained to detect the scent of C. difficile.
Jaime Kinna has been involved with working dogs for over 10 years. She has handled and trained detection dogs in explosives, narcotics and bed bugs. Jaime joined our team in December 2017 and is Dodger's partner/handler.
We provide C. difficile canine scent detection services to hospitals & long-term care facilities.
Rapid & accurate identification of C. difficile environmental reservoirs.
In-the-moment staff education opportunities upon alert.
Identifying trends in alert data that can be used to improve infection and control practices.
Access to professional canine detection teams with hospital experience and knowledge in infection control theory and practices.
Increased awareness of C. difficile among staff, patients, and visitors.
We provide program development support to healthcare organizations interested in developing their own C. difficile canine scent detection program.
"[Canine scent detection] is an innovative and exciting way to discover new places where C diff might reside. That way we can immediately target problem areas for cleaning and disinfection."
- Rita Dekleer, Infection Control Practitioner, VCH
"Having our Infection Control Practitioner attend rounds with Teresa & Angus helps us because we can ask more detailed questions about C diff, how it is spread, antibiotic utilization, etc."
- Jackson Lam, Patient Service Manager, VCH
"Having Angus and Teresa as part of our IPAC team has a profound impact on our program and has impacted hospital staff in general in a very positive way. Angus is loved and respected "staff member "off VGH IPAC team. He captures the attention of the hospital staff, patients, and family, and he is giving Infection Control great PR. Canine scent detection is providing us with a new type of environmental data that has not been readily available before. Nothing can replace sensitivity of Angus's nose. Quick and swift action following Angus alert is very reassuring to all of us who are striving to provide best patient care. "
- Amira Imamovic Buljubasic, Infection Control Practitioner, VCH
"When Teresa & Angus walk through the units, they brighten up everyone's day! The environmental services staff enjoy working closely with them and are always interested to find the results of their searches so they can make sure there are no gaps in cleaning practices."
- Ray Rahiman, Operations Manager, Crothall Healthcare, a division of Compass Group Canada
Our training protocols & validation test were developed based on best practices from the Scientific Working Group on Dog & Orthogonal Detector Guidelines (SWGDOG), and the National Detector Dog Manual, created by the U.S. Department of Agriculture. We have also adapted our training protocols & validation test to reflect the unique challenges canine detection teams will face when detecting C. difficile in hospitals. Our validation process includes, but is not limited to, using a double testing format (as recommended by SWGDOG) along with the addition of an odour recognition test, and search capable test in the validation test. Additionally, our canine detection teams are validated yearly by an independent validator.
We have trained and validated two dogs, and are in the process of training two more dogs.
We only use toxigenic strains in our training scent kits. Thus, we do not know if our dogs can differentiate between non-toxigenic and toxigenic strains.
We look for the right personality traits such as great work ethic, integrity, teamwork skills, willingness to learn, and aptitude for working in the healthcare environment. All of our handlers possess a strong knowledge of how odour works, along with a strong understanding of their dog’s communication. Our canine handlers also have a minimum of two years of experience working with detection dogs as part of validated canine detection teams.
While all working breeds have proven themselves to be able to do detection, there are some traits in dogs that lend themselves better to this type of detection service:
- Floppy eared dogs instead of pointy eared dogs, as they are less intimidating to staff, patients, and visitors.
- Small to medium size so they can fit into tight spaces, such as in between medical equipment & patient beds.
- Dogs with exceptionally high drive.
- Good health.
- Has not been trained to detect other types of odours.
Please contact us if you would like further advice on selecting the right dog for this job.
Similar to humans, dogs are more susceptible to contracting C. difficile from the environment if they are immunocompromised. Our dogs receive regular veterinary check-ups, and are only brought into the healthcare environment upon receiving a clean bill of health.
We have received an overwhelmingly positive response from staff, patients, and visitors. As part of our program, our canine handlers also act as infection control & prevention ambassadors to increase C. difficile infection awareness & promote good practices.
Our canine detection teams do not search surgical suites, food preparation areas, neonatal units, psychiatric units, palliative care units, and offices outside of patient units. We also only search occupied patient rooms if we are accompanied by a staff member, and have permission from the patient. We do not search people.
It depends – the amount of time it takes for the canine detection team to search a patient unit is dependent on the size of the unit, extent of contamination, and the amount of in-the-moment education provided upon identification of contamination.