title: Survey of Clostridium difficile infection surveillance systems in Europe, 2011.
abstract: To develop a European surveillance protocol for Clostridium difficile infection (CDI), existing national CDI surveillance systems were assessed in 2011. A web-based electronic form was provided for all national coordinators of the European CDI Surveillance Network (ECDIS-Net). Of 35 national coordinators approached, 33 from 31 European countries replied. Surveillance of CDI was in place in 14 of the 31 countries, comprising 18 different nationwide systems. Three of 14 countries with CDI surveillance used public health notification of cases as the route of reporting, and in another three, reporting was limited to public health notification of cases of severe CDI. The CDI definitions published by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the European Centre for Disease Prevention and Control (ECDC) were widely used, but there were differing definitions to distinguish between community- and healthcare-associated cases. All CDI surveillance systems except one reported annual national CDI rates (calculated as number of cases per patient-days). Only four surveillance systems regularly integrated microbiological data (typing and susceptibility testing results). Surveillance methods varied considerably between countries, which emphasises the need for a harmonised European protocol to allow consistent monitoring of the CDI epidemiology at European level. The results of this survey were used to develop a harmonised EU-wide hospital-based CDI surveillance protocol.
authors.affiliation: Charité - Universitätsmedizin Berlin, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Kola
authors.forename: Camilla
authors.initials: C
authors.lastname: Wiuff
authors.forename: Thomas
authors.initials: T
authors.lastname: Akerlund
authors.forename: Birgit H
authors.initials: BH
authors.lastname: van Benthem
authors.forename: Bruno
authors.initials: B
authors.lastname: Coignard
authors.forename: Outi
authors.initials: O
authors.lastname: Lyytikäinen
authors.forename: Doris
authors.initials: D
authors.lastname: Weitzel-Kage
authors.forename: Carl
authors.initials: C
authors.lastname: Suetens
authors.forename: Mark H
authors.initials: MH
authors.lastname: Wilcox
authors.forename: Ed J
authors.initials: EJ
authors.lastname: Kuijper
authors.forename: Petra
authors.initials: P
authors.lastname: Gastmeier
mesh_terms: D002984:Clinical Laboratory Information Systems; D016360:Clostridioides difficile / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D003015:Clostridium Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D018563:Disease Notification / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016133:Polymerase Chain Reaction; D011159:Population Surveillance / Q000379:methods*; D062486:Public Health Surveillance / Q000379:methods*; D021521:Ribotyping; D011795:Surveys and Questionnaires
keywords: CDI; Clostridium difficile; Europe; protocol; surveillance