Voluntary Surveillance of Clostridium difficile

1. Voluntary reporting of C. difficile positive stool samples

Surveillance of positive C. difficile laboratory samples in England and Wales was introduced in 1990 as part of the Public Health Laboratory Service’s voluntary monitoring of infectious diseases caused by the main human pathogens. In 2001, this surveillance was extended to include Northern Ireland. Most of the information is received through electronic reporting to the HPA’s database (LabBase) by laboratories; the remainder are obtained from paper records. Additional information on reported cases may include patient details such as age and sex, details of detection methods used, and some antibiotic susceptibility results.

Results of the voluntary reporting scheme for Clostridium difficile, England, Wales and Northern Ireland

This report covers voluntary reports of Clostridium difficile positive faecal samples made to the HPA for 2008 for all ages from laboratories in England, Wales, and Northern Ireland. Age specific rates of C. difficile were calculated using Office of National Statistics 2008 mid-year resident population estimates as denominators.

Current report

Health Protection Agency: Voluntary Surveillance of Clostridium difficile associated disease in England, Wales and Northern Ireland, 2010 (PDF, 229 KB)

Previous publications

Health Protection Agency: Voluntary Surveillance of Clostridium difficile assoicated disease in England, Wales and Northern Ireland, 2009 (PDF, 196 KB)

Health Protection Agency: Voluntary Surveillance of Clostridium difficile associated disease in England, Wales and Northern Ireland, 2008 (PDF, 266 KB) 

Health Protection Agency: Voluntary Surveillance of Clostridium difficile associated disease in England, Wales and Northern Ireland, 2007 (PDF, 185 KB)

Health Protection Agency: Voluntary Surveillance of Clostridium difficile associated disease in England, Wales and Northern Ireland, 2006 (PDF, 109 KB)

Health Protection Agency: Voluntary Surveillance of Clostridium difficile associated disease in England, Wales and Northern Ireland, 2005 (PDF, 141 KB)

Health Protection Agency. Clostridium difficile, England, Wales, and Northern Ireland: 2004. Commun Dis Rep CDR Wkly [serial online] 15(20 )

Health Protection Agency. Clostridium difficile, England, Wales, and Northern Ireland: 2003. Commun Dis Rep CDR Wkly [serial online] 15(7) 

Health Protection Agency. Clostridium difficile: England, Wales, Northern Ireland, 2000 to 2002. Commun Dis Rep CDR Wkly [serial online] 13(40): bacteraemia

2. Submission of isolates to ARU for typing outside of the random sampling scheme schedule

Typing of C. difficile isolates can be ordered:

• to investigate local epidemiology of potentially related cases
• to monitor the presence of particular strains associated with severe disease eg PCR ribotype 027.

Isolates of C. difficile must be sent as a pure culture and may either be swabbed into transport swab/medium off a non-selective medium or inoculated from a non-selective agar into cooked-meat broth for incubation for 24hrs prior to sending to Cardiff.

N.B. Faecal samples are NOT accepted.