While positive steps have been made to control the C. difficile outbreak in several Niagara-area hospitals, poor facilities and poor practices haven't helped, says a provincially sanctioned report.

The report, released Wednesday, found that not every clinical area in the hospitals has a hygiene sink and not every patient room has its own washroom.

Good hygiene, including frequent hand-washing, is considered crucial in controlling the bacterium's spread.

The four infection control experts behind the report were particularly alarmed by the grouping of patients suspected of having the bacterium with those whose infections had been confirmed.

They also urged that extra housekeeping staff hired to help prevent the outbreak from spreading should be given permanent positions.

The outbreak began at a hospital in St. Catharines on May 28 and spread from there. Cases turned up at the Greater Niagara General Hospital and the Welland Hospital on June 23.

There have been 44 total cases in St. Catharines, 15 at Greater Niagara and 15 in Welland.

As a result of the outbreaks, the Niagara Health System called for the infection control team to review their attempts to fight the outbreak. The team visited on June 29.

At least 22 people have died from the C. difficile outbreak. The latest death occurred on the weekend at Guelph General Hospital.

C. difficile is more formally known as Clostridium difficile. It is very common in hospitals and long-term care facilities.

The bacterium causes diarrhea. It can be deadly in older patients who have underlying health conditions such as inflammatory bowel disease or immune system disorders.