Sentinel surveillance and epidemiology of Clostridioides difficile in Denmark, 2016 to 2019
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Sentinel surveillance and epidemiology of Clostridioides difficile in Denmark, 2016 to 2019. / Persson, Søren; Nielsen, Hans Linde; Coia, John Eugenio; Engberg, Jørgen; Olesen, Bente Scharvik; Engsbro, Anne Line; Petersen, Andreas Munk; Holt, Hanne Marie; Lemming, Lars; Marmolin, Ea Sofie; Søndergaard, Turid Snekloth; Andersen, Leif Percival; Jensen, Mie Birgitte Frid; Wiuff, Camilla; Sørensen, Gitte; Nielsen, Sofie Holtsmark; Nielsen, Eva Møller.
I: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin, Bind 27, Nr. 49, 2200244, 2022.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Sentinel surveillance and epidemiology of Clostridioides difficile in Denmark, 2016 to 2019
AU - Persson, Søren
AU - Nielsen, Hans Linde
AU - Coia, John Eugenio
AU - Engberg, Jørgen
AU - Olesen, Bente Scharvik
AU - Engsbro, Anne Line
AU - Petersen, Andreas Munk
AU - Holt, Hanne Marie
AU - Lemming, Lars
AU - Marmolin, Ea Sofie
AU - Søndergaard, Turid Snekloth
AU - Andersen, Leif Percival
AU - Jensen, Mie Birgitte Frid
AU - Wiuff, Camilla
AU - Sørensen, Gitte
AU - Nielsen, Sofie Holtsmark
AU - Nielsen, Eva Møller
PY - 2022
Y1 - 2022
N2 - BackgroundSince 2008, Danish national surveillance of Clostridioides difficile has focused on binary toxin-positive strains in order to monitor epidemic types such as PCR ribotype (RT) 027 and 078. Additional surveillance is needed to provide a more unbiased representation of all strains from the clinical reservoir.AimSetting up a new sentinel surveillance scheme for an improved understanding of type distribution relative to time, geography and epidemiology, here presenting data from 2016 to 2019.MethodsFor 2─4 weeks in spring and autumn each year between 2016 and 2019, all 10 Danish Departments of Clinical Microbiology collected faecal samples containing toxigenic C. difficile. Isolates were typed at the national reference laboratory at Statens Serum Institut. The typing method in 2016-17 used tandem-repeat-sequence typing, while the typing method in 2018-19 was whole genome sequencing.ResultsDuring the study period, the sentinel surveillance scheme included ca 14-15% of all Danish cases of C. difficile infections. Binary toxin-negative strains accounted for 75% and 16 of the 20 most prevalent types. The most common sequence types (ST) were ST2/13 (RT014/020) (19.5%), ST1 (RT027) (10.8%), ST11 (RT078) (6.7%), ST8 (RT002) (6.6%) and ST6 (RT005/117) (5.1%). The data also highlighted geographical differences, mostly related to ST1 and temporal decline of ST1 (p = 0.0008) and the increase of ST103 (p = 0.002), ST17 (p = 0.004) and ST37 (p = 0.003), the latter three binary toxin-negative.ConclusionSentinel surveillance allowed nationwide monitoring of geographical differences and temporal changes in C. difficile infections in Denmark, including emerging types, regardless of binary toxin status.
AB - BackgroundSince 2008, Danish national surveillance of Clostridioides difficile has focused on binary toxin-positive strains in order to monitor epidemic types such as PCR ribotype (RT) 027 and 078. Additional surveillance is needed to provide a more unbiased representation of all strains from the clinical reservoir.AimSetting up a new sentinel surveillance scheme for an improved understanding of type distribution relative to time, geography and epidemiology, here presenting data from 2016 to 2019.MethodsFor 2─4 weeks in spring and autumn each year between 2016 and 2019, all 10 Danish Departments of Clinical Microbiology collected faecal samples containing toxigenic C. difficile. Isolates were typed at the national reference laboratory at Statens Serum Institut. The typing method in 2016-17 used tandem-repeat-sequence typing, while the typing method in 2018-19 was whole genome sequencing.ResultsDuring the study period, the sentinel surveillance scheme included ca 14-15% of all Danish cases of C. difficile infections. Binary toxin-negative strains accounted for 75% and 16 of the 20 most prevalent types. The most common sequence types (ST) were ST2/13 (RT014/020) (19.5%), ST1 (RT027) (10.8%), ST11 (RT078) (6.7%), ST8 (RT002) (6.6%) and ST6 (RT005/117) (5.1%). The data also highlighted geographical differences, mostly related to ST1 and temporal decline of ST1 (p = 0.0008) and the increase of ST103 (p = 0.002), ST17 (p = 0.004) and ST37 (p = 0.003), the latter three binary toxin-negative.ConclusionSentinel surveillance allowed nationwide monitoring of geographical differences and temporal changes in C. difficile infections in Denmark, including emerging types, regardless of binary toxin status.
KW - Humans
KW - Clostridioides difficile/genetics
KW - Clostridioides/genetics
KW - Sentinel Surveillance
KW - Clostridium Infections/epidemiology
KW - Ribotyping/methods
KW - Denmark/epidemiology
U2 - 10.2807/1560-7917.ES.2022.27.49.2200244
DO - 10.2807/1560-7917.ES.2022.27.49.2200244
M3 - Journal article
C2 - 36695439
VL - 27
JO - Eurosurveillance
JF - Eurosurveillance
SN - 1025-496X
IS - 49
M1 - 2200244
ER -
ID: 334021993