Communicable Disease Surveillance & Prevention

Clostridium difficile Infection (CDI) Surveillance


C diff.The purpose of the surveillance for CDI is to determine the population-based incidence of community–and healthcare-associated CDI in the Rochester area hospitals; characterize C. difficile strains that are responsible for CDI with an emphasis on strains from community-associated cases; and describe the epidemiology of CDI.

Goals and Objectives

  • Determine the population-based incidence of community- and healthcare-associated CDI among participating EIP sites.
  • Characterize C. difficile strains that are responsible for CDI in the population under surveillance with a focus on strains from community-associated cases.
  • Describe the epidemiology of community- and healthcare-associated CDI and generate hypotheses for future research activities using EIP CDI surveillance infrastructure.


CDI laboratory-based surveillance is conducted for all positive C. difficile tests using a weekly list provided by participating EIP sites. Cases are evaluated and classified as either community onset (healthcare associated or community associated) or healthcare onset. Each presumptive community associated case, each community onset health care associated case, and a 10% sample of health care onset cases require full chart review to complete case report forms. Select participating laboratories will save stool samples from cases of CDI for further laboratory evaluation including culture and toxin type testing performed at NYS Wadsworth Laboratory or CDC.


  • Chitnis A, Holzbauer S, Belflower R, Winston L, Bamberg W, Lyons C, Farley M, Dumyati G, Wilson L, Beldavs Z, Dunn J, Gould L, Maccannell D, Gerding D, McDonald L, Lessa F. Epidemiology of Community-Associated Clostridium difficile Infection, 2009 Through 2011. JAMA Intern Med. 2013 Jun 17:1-9. PMID: 23780507
  • Dumyati G, Stevens V, Hannett GE, Thompson AD, Long C, MacCannell D, et al. Community-associated Clostridium difficile infections, Monroe County, New York, USA. Emerg Infect Dis 2012 Mar 18:(3):392-400.PMID: 22377231
  • Pawar D, Tsay R, Nelson D, Kumari M, Lessa F, McDonald C, Dumyati G. Burden of Clostridium difficile Infection in Long-Term Care Facilities in Monroe County, New York. Infection Control and Hospital Epidemiology, Vol. 33, No. 11 (November 2012) pp. 1107-1112.PMID: 23041808 [PubMed - in process]

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Contact Us

Contact the Communicable Disease Surveillance and Prevention program at (585) 224-3075 or by email at Center for Community Health.