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Mandatory surveillance of Clostridium difficile

The results of the mandatory Clostridium difficile enhanced surveillance scheme:

  • 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.

Background information

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.

The following statement outlines the case definition:

'...reporting of cases in the mandatory surveillance system should be based upon the diagnosis made according to the algorithm used; if the patient has been diagnosed as a case of CDI according to the diagnostic system used, then it should be reported as a positive case.'

Professor Brian Duerden, An Inspector Calls, British Infection Society/Association of Medical Microbiologists newsletter, March 2010 (http://www.britishinfection.org/drupal/sites/default/files/newsletter/BISAMM%20Newsletter%20March2010.pdf)

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.