Clostridioides difficile ribotyping network (CDRN): guide to services
The CDRN laboratory provides timely access to Clostridioides difficile culture, ribotyping and DNA fingerprinting services, according to standardised submission criteria.
National CDRN services are centralised at UKHSA Laboratory Leeds (Reference Laboratory, Leeds Teaching Hospitals Trust).
The service can be used to investigate clusters of cases of C. difficile infection and provides timely information to help optimise the management of C. difficile locally.
The CDRN service should be used by hospitals or infection control teams in England to investigate any of the following:
- increased frequency of cases or high baseline rates of C. difficile infection (CDI)
- failure to meet a trajectory or target for CDI
- increased severity or complications of cases of C. difficile infection
- increased mortality associated with C. difficile infection
- increased recurrence rate of C. difficile infection
The CDRN service can help local teams to meet targets that have been set for reducing the incidence of C. difficile infection. Additionally, it will collect, via a mandatory request form, antibiotic risk and outcome data that can be used to provide more detailed information about C. difficile infection at a national level. An electronic requesting and reporting system is now available, which increases the efficiency of the service and enhances data outputs.
Further DNA fingerprinting using multilocus variable repeat analysis (MLVA) can be carried out on request, if the criteria for enhanced fingerprinting are met.
A national sentinel surveillance scheme has been introduced to characterise isolates from CDI cases referred from pre-determined locations, using whole genome sequencing technique.
Accessing the CDRN service
- Clostridioides difficile ribotyping service: how to access the service
- Clostridioides difficile ribotyping network for England (CDRNE): enhanced fingerprinting service
- Clostridioides difficile national sentinel surveillance scheme
CDRN electronic requesting system (ERS)
The electronic requesting system (ERS) allows NHS trusts to make electronic requests for C. difficile ribotyping (and chosen trusts to make submissions to the national sentinel surveillance scheme) directly. The system allows electronic communications associated with the status of testing to be sent to the original requester, as well as other scientific and clinical staff at the requesting NHS trust.
ERS is only available to users on the NHS N3 network.
Contact
For clinical service support, email Professor Mark Wilcox mark.wilcox@nhs.net
For service and laboratory support, email
leedsth-tr.clostridiumdifficile-ribotypingnetwork@nhs.net
or email Dr Warren Fawley warren.fawley@nhs.net
Updates to this page
-
Link to and information about Clostridioides difficile national sentinel surveillance scheme added.
-
Updated information.
-
Amended list of participating laboratories.
-
First published.