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Clostridium difficile

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Clostridium Difficile bacteria

All NHS Trusts in Wales are required to undertake surveillance of the number of cases of Clostridium difficile infection.

Due to the nature of the infection, the surveillance of Clostridium difficile was originally only undertaken for in-hospital patients aged over 65. Any patients who had developed diarrhoea during their stay were also included.

However, following concerns and an increase in rates of the infection in England, the Welsh Healthcare Associated Infection Sub-group (WHAISG) established a working group. Their task was to consider the surveillance programme in Wales as well as other issues regarding Clostridium difficile.

The recommendations of the Clostridium difficile task group were accepted by WHAISG on the 8th May 2008. The recommendations included the following relevant to the surveillance programme:

  • expansion of the mandatory surveillance scheme to include all inpatients 2 years and above, (a high percentage of Clostridium difficile are colonising organisms in the under 2 year age group and not clinically relevant)
  • enhanced surveillance information linked to strain typing to be collected on a percentage of cases from each laboratory
  • the development of an agreed protocol for the laboratory testing of specimens for Clostridium difficile from all patients of whatever age. It is recognised that standardisation of testing is required to produce comparable data.

Following the acceptance of the Clostridium difficile task group, the Welsh Healthcare Associated Infections Programme team will be taking forward implementation of the enhanced Clostridium difficile surveillance scheme.

Further details can be found on the Welsh Healthcare Associated Infections Programme website (external link)

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