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Clostridium difficile Mandatory Surveillance

Mandatory C. difficile  infection (CDI) surveillance scheme

As of April 2007 all acute NHS Trusts in England are required to report all cases of CDI in patients aged 2 years and over. Reports are submitted using the same web-enabled system that is used to collect enhanced MRSA bacteraemia data. The surveillance includes the collection of patient details for each CDI episode such as NHS number, hospital number, date of birth, and sex, as well as information concerning the patient's location, date of admission, and care details at the time the faecal sample was taken. Cases are defined as all diarrhoeal specimens that test positive for C. difficile toxin (where the patient has not been diagnosed with CDI in the preceding four weeks).

The CMO/CNO letter outlining these changes can be found under the Guidelines section of the website.

The HPA produces tables of counts of CDI on a monthly and annual basis. Every quarter the data collected in the enhanced surveillance is used to produce epidemiological commentaries with the aim of contributing to a better evidence base regarding risk factors for infection.

  • C. difficile infection tables - Monthly: Acute Trust and Primary Care Organisation (PCO) results by month for a 13 month period.
  • C. difficile infection tables - Annual: Acute Trust and Primary Care Organisation (PCO) results by quarter and by financial year. April 2007 onwards.
  • C. difficile commentaries - Quarterly: Commentary on trends over a period of 9 quarters.