Publication date: August 2011
The Clostridium difficile Ribotyping Network (CDRN) for England and Northern Ireland has continued to expand and respond to a major public health need by providing a molecular epidemiological service that enhances our understanding of this pathogen. The proportion of all reported CDI cases in England for which samples are submitted to CDRN continues to increase.
Since the introduction of the CDRN, reports of C. difficile in England have fallen markedly. Reports of deaths associated with CDI have also now started to decrease, which could be due to enhanced control of the epidemic ribotype C. difficile 027. It is not possible to determine which interventions have been particularly responsible for the decreased incidence of CDI. We believe that the timely data provided by the CDRN has enabled healthcare institutions to respond to changes in CDI presentation and/or incidence. We note that there is currently evidence of a plateau effect for the incidence of CDI reports.
We encourage all hospitals to consider submitting samples according to the CDRN criteria so that they can be best placed to continue to prevent and control CDI. This will also afford the greatest chance of identifying emergent C. difficile ribotypes.
Erratum: this is the second version of this document issued 24 August 2011. Charts have been added for the East Midlands, which were missing from the first version, published in February 2011.
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Last reviewed: 20 January 2012