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How to: Surveillance of Clostridium difficile infections
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Orientador(es)
Resumo(s)
Background: The increasing incidence of Clostridium difficile infections (CDI) in healthcare settings in
Europe since 2003 has affected both patients and healthcare systems. The implementation of effective
CDI surveillance is key to enable monitoring of the occurrence and spread of C. difficile in healthcare and
the timely detection of outbreaks.
Aims: The aim of this review is to provide a summary of key components of effective CDI surveillance
and to provide some practical recommendations. We also summarize the recent and current national CDI
surveillance activities, to illustrate strengths and weaknesses of CDI surveillance in Europe.
Sources: For the definition of key components of CDI surveillance, we consulted the current European
Society of Clinical Microbiology and Infectious Diseases (ESCMID) CDI-related guidance documents and
the European Centre for Disease Prevention and Control (ECDC) protocol for CDI surveillance in acute
care hospitals. To summarize the recent and current national CDI surveillance activities, we discussed
international multicentre CDI surveillance studies performed in 2005e13. In 2017, we also performed a
new survey of existing CDI surveillance systems in 33 European countries.
Content: Key components for CDI surveillance are appropriate case definitions of CDI, standardized CDI
diagnostics, agreement on CDI case origin definition, and the presentation of CDI rates with well-defined
numerators and denominators. Incorporation of microbiological data is required to provide information
on prevailing PCR ribotypes and antimicrobial susceptibility to first-line CDI treatment drugs. In 2017, 20
European countries had a national CDI surveillance system and 21 countries participated in ECDCcoordinated CDI surveillance. Since 2014, the number of centres with capacity for C. difficile typing has
increased to 35 reference or central laboratories in 26 European countries.
Implications: Incidence rates of CDI, obtained from a standardized CDI surveillance system, can be used
as an important quality indicator of healthcare at hospital as well as country level.
Descrição
The survey contributors: INSA - M. Oleastro (National Institute of Health Dr Ricardo Jorge, Lisboa, Portugal)
Supplementary data related to this article can be found at https://doi.org/10.1016/j.cmi.2017.12.008.
Supplementary data related to this article can be found at https://doi.org/10.1016/j.cmi.2017.12.008.
Palavras-chave
Algorithms Clostridium Infections Cross Infection Disease Outbreaks Europe Humans Incidence Quality Indicators, Health Care Clostridium difficile Public Health Surveillance Infecções Gastrointestinais
Contexto Educativo
Citação
Clin Microbiol Infect. 2018 May;24(5):469-475. doi: 10.1016/j.cmi.2017.12.008. Epub 2017 Dec 20
Editora
Elsevier/ European Society of Clinical Microbiology and Infectious Diseases