Case definition for hospital-identified CDI:
A hospital-identified CDI case is a case of CDI identified for a patient attending a hospital (including positive specimens obtained from admitted patients and those attending the emergency department, and outpatient departments). This does not mean the case of CDI is attributed to or acquired at the hospital conducting the surveillance.
A case of CDI implies that the patient has the relevant clinical manifestations and must meet either: 1) Criterion A and either Criterion B1 or B2; or 2) Criterion A and Criterion C.
A case of hospital-identified CDI:
Not a case of hospital-identified CDI:
Criterion A: Diarrhoea (usually defined as three or more loose stools in a 24-hour period) or, less commonly, ileus, toxic megacolon or pseudomembranous colitis (identified by colonoscopy).
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AND EITHER
Microbiological evidence of toxin producing C. difficile from at least one of the following criteria:
Criterion B1: Positive test laboratory test result for C. difficile toxin A and /or B tested on an unformed (diarrhoea) stool specimen.
OR
Criterion B2: A toxin-producing C. difficile organism detected by culture or other laboratory means performed on an unformed stool sample.
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OR
Criterion C: Patient has evidence of pseudomembranous colitis on gross anatomic (includes endoscopic exams) or histopathologic exam.
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Exclusions:
- Cases where a known previous positive test has been obtained within the last eight weeks
- Patients less than two years old at date of admission.
For guidance on testing procedures for C. difficile see Public Health Laboratory Network. Clostridium difficile infection laboratory case definition: