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Clostridium difficile infection:mandatory surveillance 2017/18Summary of the Mandatory SurveillanceAnnual Epidemiological Commentary2017/18
Clostridium difficile infection: mandatory surveillance 2017/18About Public Health EnglandPublic Health England exists to protect and improve the nation’s health and wellbeing,and reduce health inequalities. We do this through world-leading science, knowledgeand intelligence, advocacy, partnerships and the delivery of specialist public healthservices. We are an executive agency of the Department of Health and Social Care,and a distinct delivery organisation with operational autonomy. We providegovernment, local government, the NHS, Parliament, industry and the public withevidence-based professional, scientific and delivery expertise and support.Public Health EnglandWellington House133-155 Waterloo RoadLondon SE1 8UGTel: 020 7654 8000www.gov.uk/pheTwitter: @PHE ukFacebook: www.facebook.com/PublicHealthEnglandPrepared by: Simon Thelwall, Olisaeloka Nsonwu, Graeme Rooney, Sobia Wasti,Jeremy Anselmo, Russell HopeFor queries relating to this document, please contact:[email protected] Crown copyright 2018You may re-use this information (excluding logos) free of charge in any format ormedium, under the terms of the Open Government Licence v3.0. To view this licence,visit OGL. Where we have identified any third party copyright information you will needto obtain permission from the copyright holders concerned.Published July 2018PHE publicationsgateway number: 2018236PHE supports the UNSustainable Development Goals2
Clostridium difficile infection: mandatory surveillance 2017/18ContentsAbout Public Health England2Summary4Summary points on Clostridium difficile InfectionTotal reportsHospital-onset reportsNotes4446References73
Clostridium difficile infection: mandatory surveillance 2017/18SummarySummary points on Clostridium difficile InfectionC. difficile data has been published (12 July 2018) as part of the Department of Healthand Social Care's mandatory surveillance programme for healthcare-associatedinfection. [1]Newly published data includes: annual (April 2017 to March 2018) counts and rates of CDI by acute trust andclinical commissioning group (CCG)Total reportsA total of 13,286 cases of Clostridium difficile infection were reported by NHS Trusts inEngland between 1 April 2017 and 31 March 2018. This translates to a small increaseof 3.4% from 2016/17 (n 12,845), and a decrease of 76.1% from 2007/08 (n 55,498). Figure 1 shows the trends in rates of CDI cases for all cases and hospitalonset cases from 2007/08 to 2016/17. The rate of all CDI cases per 100,000 population,per year has fallen from 100.3 in 2007/08 to 24 in 2017/18.Hospital-onset reportsOf the 13,286 total cases reported in FY 2017/18, 4,739 were hospital-onset (13.7 per100,000 bed-days). It should be noted that CDI cases are considered hospital-onset ifthey occur 4 days after admission to an acute trust, where day of admission is day 1.This is in contrast to 3 days for bacteraemia cases. The incidence rate for hospitalonset CDI cases mirrors the trends in incidence for all cases, with declining rates from2007/08 to 2013/14 which then remained approximately stable to 2017/18. The rate ofhospital-onset CDI cases increased slightly from 13.2 in 2016/17 to 13.7 in 2017/18, achange of 3.3%4
Clostridium difficile infection: mandatory surveillance 2017/18Figure 1: Trends in the rate of C. difficile infection in England* Mid-year population estimates for 2017/18 were not available at time of publication and so populationdata for 2016/17 were used as a proxy.** bed day data were not available for quarter 4 of FY 2017/18 (January to March, 2018). As a result,the 2017/18 bed day data is an aggregate of quarters 1, 2 and 3 of 2017/18 and quarter 4 of 2016/17.5
Clostridium difficile infection: mandatory surveillance 2017/18NotesThis publication forms part of the range of National Statistics outputs routinely producedby PHE. Further detailed epidemiological analyses of MRSA bacteraemia, MSSAbacteraemia, Gram negative bacteraemias and CDI data can be found in both theQuarterly Epidemiological Commentaries [2] and the Annual EpidemiologicalCommentary, 2017/18 data. [3] The Annual Epidemiological Commentary for FY2017/18 contains analyses equivalent to previous years, including counts and rates perfinancial year by age, sex and region (NHS England Local Office).6
Clostridium difficile infection: mandatory surveillance 2017/18ReferencesBibliography[1] Public Health England, “MRSA, MSSA and E. coli bacteraemia and CDI: annual report,” July2018. [Online]. Available: nnual-epidemiological-commentary.[2] Public Healt England, “MRSA, MSSA, Gram-negative bacteraemia and CDI: quarterlyreport,” Public Healt England, London, 2018.[3] Public Health England, “Annual epidemiological commentary: MRSA, MSSA and E. colibacteraemia and C. difficile infection data, up to and including financial year April 2017 toMarch 2018,” Public Health England, London, 2018.7
onset cases from 2007/08 to 2016/17. The rate of all CDI cases per 100,000 population, per year has fallen from 100.3 in 2007/08 to 24 in 2017/18. Hospital-onset reports Of the 13,286 total cases reported in FY 2017/18, 4,739 were hospital-onset (13.7 per 100,000 bed-days). It should be noted that CDI cases are considered hospital-onset if
