An increase in CDI rates is an additional indicator complementing antibiotic consumption. Antibiotics alter the normal intestinal flora and can cause colitis linked to Clostridioides difficile infection (CDI). CDI prolongs hospital stays and leads to morbidity and increased mortality. CDI in hospitals is in part attributable to antimicrobial consumption and other risk factors and in-hospital transmission.

(1) Have an established surveillance of CDI

The surveillance of CDI is often based on laboratory data. ANRESIS is developing a platform for CDI lab surveillance. If the local microbiology lab does not yet participate, the hospital might aim for joining the ANRESIS surveillance system.

(2) Ensure the surveillance of CDI is user-friendly and used

Insure that AMS and IPC have established a joint process to investigate the increase of CDI rates. The investigation process should address inhospital transmission, prescribing practices, and other causes. Furthermore, it should make recommendations for improvement to the relevant groups (leaders of clinical departments, governance structure).

(3) Metrics

Monitoring trends in antimicrobial consumption and audit results can indicate whether prescribing has improved. Access statistics can give hints as to whether CDI surveillance data are used.
If there is no visible effect, ensure that local practice and the further development of ASP are discussed in relevant committees.

More tools for local C. difficile monitoring are being prepared and will be offered by 2026.