Nova Scotia's health authorities say their numbers of C. difficile cases remain stable following an outbreak at Sydney-area hospitals.

The Cape Breton District Health Authority reports 21 cases of the bacterial infection. Four patients have died in the past few weeks.

The province's infection prevention control centre has been busy fielding calls.

"A lot of calls from both long-term care and acute care wondering how to manage patients that maybe have developed signs and symptoms of C. difficile," said Suzanne Rhodenizer-Rose, with the centre.

Most health districts have an infectious control specialist on staff. They promote frequent hand-washing and disinfecting of rooms and materials.

The Pictou County Health Authority has a program that limits the amount of antibiotics for patients and, it's believed, limits their susceptibility to C. difficile.

"It's an activity or program that includes the appropriate selection, dosing, route and duration of all antibiotic therapy within the organization," said Janice Kaffer, vice-president of clinical services.

Kaffer said the district is seeing fewer cases of C. difficile.

Most districts have had between one and five cases so far this year.