Collection

Clostridium difficile: guidance, data and analysis

The characteristics, diagnosis, management, surveillance and epidemiology of Clostridium difficile (C. difficile).

Published 1 July 2014
Last updated 9 March 2018 — see all updates

• From: Public Health England

Clostridium difficile (C. difficile) is a bacterium that’s found in people’s intestines. It can be found in healthy people, where it causes no symptoms (up to 3% of adults and 66% of babies).

C. difficile causes disease when the normal bacteria in the gut are disadvantaged, usually by someone taking antibiotics. This allows C. difficile to grow to unusually high levels. It also allows the toxin that some strains of C. difficile produce to reach levels where it attacks the intestines and causes mild to severe diarrhoea.

C. difficile can lead to more serious infections of the intestines with severe inflammation of the bowel (pseudomembranous colitis). C. difficile is the biggest cause of infectious diarrhoea in hospitalised patients.

You can become infected with C. difficile if you ingest the bacterium (through contact with a contaminated environment or person). People who become infected with C. difficile are usually those who’ve taken antibiotics, particularly the elderly and people whose immune systems are compromised.

Diagnosis and management

1. Clostridium difficile infection: guidance on management and treatment
   • 1 June 2013
   • Guidance
2. Clostridium difficile: updated guidance on diagnosis and reporting
   • 6 March 2012
   • Guidance
3. Clostridium difficile infection (CDI): management in care homes
   • 1 August 2010
   • Research and analysis
4. Clostridium difficile: what it is, how to prevent, how to treat
   • 1 February 2009
   • Guidance
5. Clostridium difficile infection: how to deal with the problem
   • 1 December 2008
   • Guidance

Data submission

See also guidance on the diagnosis and reporting of Clostridium difficile.

Clostridium difficile infection objectives, guidance and assessment available on the NHS Improvement website.

Clostridium difficile Infection Surveillance Update available on HCAI data capture system Help and Support page

1. Clostridium difficile infection: criteria for reporting
   • 1 January 2014
   • Guidance

Epidemiology

PHE has carried out mandatory enhanced surveillance of C. difficile infection since April 2007 for NHS acute trusts; patient-level data of any C. difficile infections are reported monthly to PHE. Independent sector (IS) healthcare organisations providing regulated activities also undertake surveillance of C. difficile infection.

1. C. difficile infection: monthly data by NHS acute trust and onset
   • 6 February 2019
   • National Statistics
2. C. difficile infection: monthly data by CCG and onset status
   • 6 February 2019
   • National Statistics
3. Clostridium difficile (C. difficile) infection: annual data
   • 12 July 2018
   • National Statistics
4. Clostridium difficile: annual trends in voluntary surveillance
   • 19 June 2015
   • Research and analysis
5. MRSA, MSSA and Gram-negative bacteraemia and CDI: annual report
   • 31 August 2018
   • National Statistics
6. MRSA, MSSA, Gram-negative bacteraemia and CDI: quarterly report
   • 13 December 2018
   • National Statistics
7. MRSA, MSSA and Gram-negative bacteraemia and Clostridium difficile infection: annual data for independent sector healthcare organisations
   • 2 October 2018
   • Official Statistics
8. MRSA, MSSA, Gram-negative bacteraemia and CDI: independent sector
   • 4 April 2018
   • Official Statistics
9. Clostridium difficile ribotyping network (CDRN) report
   • 12 January 2016
   • Research and analysis
10. MRSA, MSSA, Gram-negative bacteraemia and CDI: 30-day all-cause fatality
    • 12 October 2018
    • Official Statistics

Official statistics compliance

We produce Healthcare associated infections (HCAI) mandatory surveillance statistics publications in accordance with the code of practice for official statistics and they are designated as National Statistics. The data-specific documents below describe our compliance with aspects of the Code.

User engagement

The stakeholder engagement summary collates evidence from mandatory HCAI surveillance statistics users and provides:

• a summary of how the statistics are used
• views on how provision of the statistics meets the needs of users
• our actions in response to user feedback

We will update this document as we receive further user feedback.

Read minutes of the HCAI Mandatory Surveillance Stakeholder Engagement Forum.

1. Pre-release access list: mandatory HCAI statistical releases
   • 4 October 2017
   • Guidance
2. MRSA, MSSA and E. coli bacteraemia and C. difficile infection mandatory data: revisions and amendments policy
   • 22 March 2016
   • Guidance
3. Mandatory healthcare associated infection (HCAI) surveillance: data quality statement
   • 5 June 2018
   • Guidance

Published 1 July 2014
Last updated 9 March 2018 + show all updates

1. 9 March 2018 Added link to CDI Objectives and Assessment tool on NHS Improvement website.
2. 2 February 2017 Updated with links to the 6 June 2016 meeting.
3. 21 March 2016 Added MRSA, MSSA and E. coli bacteraemia and C. difficile infection: 30 day all-cause fatality to collection.
4. 1 July 2014 First published.