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Abstract

Background

Since 2008, Danish national surveillance of 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.

Aim

Setting 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.

Methods

For 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 . 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.

Results

During the study period, the sentinel surveillance scheme included ca 14–15% of all Danish cases of 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.

Conclusion

Sentinel surveillance allowed nationwide monitoring of geographical differences and temporal changes in infections in Denmark, including emerging types, regardless of binary toxin status.

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2022-12-08
2024-10-31
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2022.27.49.2200244
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Sentinel surveillance and epidemiology of Clostridioides difficile in Denmark, 2016 to 2019
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=S%C3%B8ren+Persson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Persson Søren</a>, <a href="/search?value1=Hans+Linde+Nielsen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nielsen Hans Linde</a>, <a href="/search?value1=John+Eugenio+Coia&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Coia John Eugenio</a>, <a href="/search?value1=J%C3%B8rgen++Engberg&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Engberg Jørgen </a>, <a href="/search?value1=Bente+Scharvik+Olesen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Olesen Bente Scharvik</a>, <a href="/search?value1=Anne+Line+Engsbro&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Engsbro Anne Line</a>, <a href="/search?value1=Andreas+Munk++Petersen&option1=author&noRedirect=true" class="nonDisambigAuthorLink"> Petersen Andreas Munk</a>, <a href="/search?value1=Hanne+Marie+Holt&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Holt Hanne Marie</a>, <a href="/search?value1=Lars+Lemming&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lemming Lars</a>, <a href="/search?value1=Ea+Sofie+Marmolin&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Marmolin Ea Sofie</a>, <a href="/search?value1=Turid+Snekloth+S%C3%B8ndergaard&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Søndergaard Turid Snekloth</a>, <a href="/search?value1=Leif+Percival+Andersen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Andersen Leif Percival</a>, <a href="/search?value1=Mie+Birgitte+Frid+Jensen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jensen Mie Birgitte Frid</a>, <a href="/search?value1=Camilla+Wiuff&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Wiuff Camilla</a>, <a href="/search?value1=Gitte+S%C3%B8rensen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sørensen Gitte</a>, <a href="/search?value1=Sofie+Holtsmark+Nielsen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nielsen Sofie Holtsmark</a>, <a href="/search?value1=Eva+M%C3%B8ller+Nielsen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nielsen Eva Møller</a></span>. Sentinel surveillance and epidemiology of Clostridioides difficile in Denmark, 2016 to 2019. <a href="/content/ecdc">Euro Surveill.</a> 2022;27(49):pii=2200244. <a href="https://doi.org/10.2807/1560-7917.ES.2022.27.49.2200244" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2022.27.49.2200244</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 09 Mar 2022;&nbsp;&nbsp; <span class="generated">Accepted</span>: 06 Jul 2022 </span> </p>
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