title: Standardised surveillance of Clostridium difficile infection in European acute care hospitals: a pilot study, 2013.
abstract: Clostridium difficile infection (CDI) remains poorly controlled in many European countries, of which several have not yet implemented national CDI surveillance. In 2013, experts from the European CDI Surveillance Network project and from the European Centre for Disease Prevention and Control developed a protocol with three options of CDI surveillance for acute care hospitals: a 'minimal' option (aggregated hospital data), a 'light' option (including patient data for CDI cases) and an 'enhanced' option (including microbiological data on the first 10 CDI episodes per hospital). A total of 37 hospitals in 14 European countries tested these options for a three-month period (between 13 May and 1 November 2013). All 37 hospitals successfully completed the minimal surveillance option (for 1,152 patients). Clinical data were submitted for 94% (1,078/1,152) of the patients in the light option; information on CDI origin and outcome was complete for 94% (1,016/1,078) and 98% (294/300) of the patients in the light and enhanced options, respectively. The workload of the options was 1.1, 2.0 and 3.0 person-days per 10,000 hospital discharges, respectively. Enhanced surveillance was tested and was successful in 32 of the hospitals, showing that C. difficile PCR ribotype 027 was predominant (30% (79/267)). This study showed that standardised multicountry surveillance, with the option of integrating clinical and molecular data, is a feasible strategy for monitoring CDI in Europe.
authors.affiliation: Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Sofie M
authors.initials: SM
authors.lastname: van Dorp
authors.forename: Pete
authors.initials: P
authors.lastname: Kinross
authors.forename: Petra
authors.initials: P
authors.lastname: Gastmeier
authors.forename: Michael
authors.initials: M
authors.lastname: Behnke
authors.forename: Axel
authors.initials: A
authors.lastname: Kola
authors.forename: Michel
authors.initials: M
authors.lastname: Delmée
authors.forename: Anastasia
authors.initials: A
authors.lastname: Pavelkovich
authors.forename: Silja
authors.initials: S
authors.lastname: Mentula
authors.forename: Frédéric
authors.initials: F
authors.lastname: Barbut
authors.forename: Agnes
authors.initials: A
authors.lastname: Hajdu
authors.forename: André
authors.initials: A
authors.lastname: Ingebretsen
authors.forename: Hanna
authors.initials: H
authors.lastname: Pituch
authors.forename: Ioana S
authors.initials: IS
authors.lastname: Macovei
authors.forename: Milica
authors.initials: M
authors.lastname: Jovanović
authors.forename: Camilla
authors.initials: C
authors.lastname: Wiuff
authors.forename: Daniela
authors.initials: D
authors.lastname: Schmid
authors.forename: Katharina Ep
authors.initials: KE
authors.lastname: Olsen
authors.forename: Mark H
authors.initials: MH
authors.lastname: Wilcox
authors.forename: Carl
authors.initials: C
authors.lastname: Suetens
authors.forename: Ed J
authors.initials: EJ
authors.lastname: Kuijper
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019411:Clinical Laboratory Techniques / Q000379:methods / Q000592:standards*; D016360:Clostridioides difficile / Q000235:genetics* / Q000302:isolation & purification; D003015:Clostridium Infections / Q000175:diagnosis*; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D016133:Polymerase Chain Reaction / Q000379:methods / Q000592:standards*; D011159:Population Surveillance / Q000379:methods*; D021521:Ribotyping / Q000592:standards*; D055815:Young Adult
keywords: Clostridium difficile; Clostridium infections in humans; Europe; Typing; epidemiology; surveillance