• Voluntary surveillance of Clostridium difficile in England, Wales and Northern Ireland, 2009

Voluntary surveillance of Clostridium difficile in England, Wales and Northern Ireland, 2009

The dataset used here comprises laboratory based surveillance of Clostridium difficile faecal samples in England and Wales that has been reported since 1990 as part of the then Public Health Laboratory Service’s voluntary monitoring of infectious diseases. From 2001, this surveillance was extended to include Northern Ireland [1].

This update describes reports of C. difficile faecal samples made to the HPA in 2009 from laboratories in England, Wales and Northern Ireland.

Key points

• There were 28,458 reports in 2009, comprising 25,719 from England, 1,754 from Wales and 985 from N. Ireland. This was a 23% decrease in the number of C. difficile laboratory reports compared to 2008 (Figure 1);
• The incidence rate of C. difficile per population have decreased in England, Wales and Northern Ireland from 63 to 50, 96 to 59 and 94 to 55 samples per 100,000 population respectively;
• Around 77% of all reported cases were in the 65 years and over age group (Figure 2);
• The number of laboratories across England, Wales and Northern Ireland reporting cases of C. difficile has decreased by 1% from 173 in 2008 to 171 in 2009. 
  

Figure 1. Voluntary laboratory reports of C. difficile positive faecal specimens: England, Wales and Northern Ireland * 1990 - 2009†

* Northern Ireland reports included from 2001
† Data from 2009 are provisional (data was extracted on 28 th January 2010).

Figure 2. Age specific rates* of C. difficile from laboratory reports under voluntary reporting scheme: England, Wales and Northern Ireland 2009†



† Data from 2009 are provisional (data was extracted on 28 January 2009).
* Rates are calculated using 2008 ONS mid-year population estimates.

Further information and analysis on Clostridium difficile infection voluntary reporting is available on the Agency's website at HPA - Clostridium difficile.

Acknowledgements
We are grateful to microbiology colleagues in NHS acute Trusts for their contributions to this reporting scheme, as well as efforts from colleagues in the regional offices of the Health Protection Agency.

Reference
1. HPA. Clostridium difficile: England, Wales and Northern Ireland, 2000 to 2002. Commun Dis Rep CDR Wkly 2003;13(40): Bacteraemia. Available at http://www.hpa.org.uk/cdr/archives/2003/bact_4003.pdf