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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.


  • Dantes R, Mu Y, Hicks L, Cohen J, Bamberg W, Beldavs Z, Dumyati G, Farley M, Holzbauer S, Meek J, Phipps E, Wilson L, Winston L, McDonald LC, and Lessa F. Association between Outpatient Antibiotic Prescribing Practices and Community-Associated Clostridium difficile Infection. (Summer 2015) 2 (3):  doi:10.1093/ofid/ofv113 Article Link
  • Baggs J, Yousey-Hindes K, Ashley ED, Meek J, Dumyati G, Cohen J, Wise M, Clifford McDonald L, Lessa FC. Identification-of-population-at-risk-for-future-CDI-following-hospital-discharge. Vaccine. 2015 Oct 5; Epub 2015 Oct 05. Article Link
  • Lessa FC, Mu Y, Bamberg WM, Beldavs ZG, Dumyati GK, Dunn JR, Farley MM, Holzbauer SM, Meek JI, Phipps EC, Wilson LE, Winston LG, Cohen JA, Limbago BM, Fridkin SK, Gerding DN, McDonald LC. Burden of Clostridium difficile in the United States. The New England journal of medicine. 2015 Feb 26; 372(9):825-34. Article Link
  • See I, Mu Y, Cohen J, Beldavs ZG, Winston LG, Dumyati G, Holzbauer S, Dunn J, Farley MM, Lyons C, Johnston H, Phipps E, Perlmutter R, Anderson L, Gerding DN, Lessa FC. NAP1 Strain Type Predicts Outcomes From Clostridium difficile Infection. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2014 May; 58(10):1394-400. Epub 2014 Mar 05. Article Link
  • Wendt JM, Cohen JA, Mu Y, Dumyati GK, Dunn JR, Holzbauer SM, Winston LG, Johnston HL, Meek JI, Farley MM, Wilson LE, Phipps EC, Beldavs ZG, Gerding DN, McDonald LC, Gould CV, Lessa FC. Clostridium difficile Infection Among Children Across Diverse US Geographic Locations. Pediatrics. 2014 Apr; 133(4):651-8. Epub 2014 Mar 03. Article Link
  • Cohen J, Limbago B, Dumyati G, Holzbauer S, Johnston H, Perlmutter R, Dunn J, Nadle J, Lyons C, Phipps E, Beldavs Z, Clark LA, Lessa FC, Impact of changes in Clostridium difficile testing practices on stool rejection policies and C. difficile positivity rates across multiple laboratories in the United States. Journal of clinical microbiology. 2014 Feb; 52(2):632-4. Epub 2013 Nov 20. Article Link
  • Rhee SM.; Tsay R.; Nelson DS.; vanWijngaarden E.; Dumyati G. "Surveillance of Clostridium difficile in the Pediatric Population of Monroe County: 2010-2011".  Journal of the Pediatric Infectious Diseases Society. 2014; 3(3): 183–188. Article Link
  • 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. Article Link
  • 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. Article Link

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