New web based system to monitor C. difficile bug
- 16 April 2007
A new web based system to enhance monitoring of the Clostridium difficile bug (C difficile) is to be introduced later this month by the Department of Health (DH), enabling acute and primary care trusts to monitor progress on local targets and to identify ‘infection hotspots’ requiring attention.
The department says the new system will both improve local monitoring and enable accurate national surveillance of C difficile.
All PCTs are now required to agree local targets with their trusts for reducing Clostridium difficile infections. This new surveillance system will allow them to monitor progress against these targets on a monthly basis. Local targets for C difficile were introduced in the NHS operating framework for 2007/08.
Modelled on the existing MRSA data collection system, the new C difficile surveillance system will provide an improved national picture on the incidence of C difficile and associated diarrhoea by collecting data on nearly all cases rather than just those over 65.
The fields required in the new system will be those to identify the case, date of birth (all cases over two years old to be reported); sex; specimen date; reporting laboratory and location of the patient at the time the specimen was taken. In addition the inclusion of the date of birth will allow comparisons with previous years’ data for the over 65s
A second voluntary page for risk factor information such as antibiotic treatment is being developed and will be available in early summer.
Chief Nursing Officer Christine Beasley said "The MRSA surveillance system is widely regarded as one of the best in the world and our experience has allowed us to learn much more about sources of infection and specialties where MRSA bacteraemia occur most often. This knowledge has helped hospitals to target these areas and drive MRSA infection rates down and we want to replicate this for C difficile."
In a letter to the NHS, Chief Nursing officer (CNO) Christine Beasley and the Chief Medical Officer (CMO) Sir Liam Donaldson stressed that accurate surveillance is essential in any strategy to reduce infections and the new system.
Under the current system, C difficile cases are reported from trust laboratories and a case is assigned to the reporting laboratory’s trust, regardless of where the patient came from. This means that if a trust laboratory carries out work for other trusts, community hospitals and primary care, their published infection rate will include these other patients, making their rate higher than it really is. Consequently, patients, their families and medical advisers may be misled over the scale of C difficile in the trust.
The new system will show where cases occur rather than just assigning all cases to the reporting laboratory’s trust, giving the public and NHS access to more accurate data. In addition a group of NHS professionals are working on a risk factor page that trusts will be able to use to identify ‘hot spots’ they should be targeting to reduce infections..
The letter from the CNO and CMO also stresses the importance of local surveillance, emphasising that trusts and SHAs must continue to have systems that provide early warning of outbreaks and allow early implementation of control measures when necessary, as well as monitoring progress against reduction targets.
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