Clostridium difficile infection in Europe: a hospital-based survey

Underdiagnosis of Clostridium difficile across Europe: the European, multicentre, prospective, biannual, point-prevalence study of Clostridium difficile infection in hospitalised patients with diarrhoea (EUCLID)

“…7 There has also been a 70% increase in reported CDI incidence from 4.1 to 7.0 CDI cases/10,000 patent bed days, despite the frequent use of sub-optimal laboratory diagnostics. 7 It should be noted, however, that CDI E 87 hospitals compared with 427-468 in the present study.…”

“…7 There has also been a 70% increase in reported CDI incidence from 4.1 to 7.0 CDI cases/10,000 patent bed days, despite the frequent use of sub-optimal laboratory diagnostics. 7 It should be noted, however, that CDI E 87 hospitals compared with 427-468 in the present study. 7 Importantly, if cases diagnosed at NCLs are used to calculate CDI incidence, the is 2.4-2.9-fold higher than the reported CDI rate (table 3).…”

“…5,6 In the most recent European epidemiological survey of CDI (2008) the incidence in 97 hospitals across 29 countries varied widely (range 0.0-36.3 per 10,000 patient bed days per hospital (PBH); weighted mean 4.1). 7 The reasons for this large variation are unclear. Predisposing factors to CDI, including increasing age, co-morbidities and use of broad-spectrum antibiotics may be similar across Europe, although exposure to different C. difficile strains likely varies.…”

“…1,8 Notably, there was a >40-fold variation in CDI testing frequency across European countries, and a correlation between testing rate and reported infection rate was found. 7 Sub-optimal case ascertainment, either due to inadequate laboratory diagnosis or lack of clinical suspicion means that the true burden of CDI is unclear. [9][10][11][12] A recent point prevalence study in Spain found that 66% of CDI patients on a single day were undiagnosed or misdiagnosed, due either to lack of clinical suspicion (47%) or inadequate laboratory testing (19%).…”

Application of Molecularbiological Methods in the Toxin-typing of Clostridium difficile

“…Clinically the most important types of C. difficile are included in several PCR ribotypes [ 2 ]. Sufficient diagnostic methods need an update in accordance with the current data of epidemiology, drug resistance and sequencing.…”