Clostridium difficile outbreak: epidemiological surveillance, infection prevention and control

Abstract

INTRODUCTION: Clostridium difficile infection (CDI) is currently considered the most common cause of health care-associated infections. The aim is to describe the trend of CDI in an Italian hospital and to assess the efficacy of the measures adopted to manage the burden. METHODS: we looked at CDI from 2016 to 2018. The incidence rate of CDIs was calculated as the number of new infected persons per month by the overall length of stay (incidence per 10,000 patient-days). Changes in the CDI rate during the period considered were analysed using a joinpoint regression model. RESULTS: thanks to the monitoring activity it was possible to adopt a new protocol, in order to manage CDI: the CDI episodes decreased from 85 in 2017 to 31 in 2018 (63% decrease). The joinpoint regression model was a useful tool to identify an important decrement during 2017, statistically significant (slope=-15.84; p= 0.012). CONCLUSIONS: reports based on routine laboratory data can accurately measure population burden of CDI with limited surveillance resources. This acitivity can help target prevention programs and evaluate their effect