Clostridioides difficile Infections (CDI)
Clostridioides difficile or Clostridioides difficile infections (CDI) have been increasing in the community and healthcare facilities, especially over the last few years. Treatment of patients with CDI is often challenging, and infections can be severe and life threatening. Since July 1, 2010, The Tennessee Department of Health (TDH) has required certain facilities to report all positive C. difficile laboratory assays for inpatients facility-wide* (with some exclusions) and for emergency departments. As of July 2012, all hospitals, regardless of average daily census (ADC), are required to report these events. Inpatient Rehabilitation Facilities have been required to report since January 2015. Monthly reporting of numerator and denominator data is ongoing in each location type unless otherwise specified. Additional reporting requirements exist for CDI related to the Emerging Infections Program; however, those requirements are not covered here.
For details on C. difficile reporting requirements for HAI surveillance, please see the information provided below.
Which health care facilities need to report?
All hospitals, excluding critical access hospitals, regardless of ADC, all long-term acute care facilities (LTACS), and all Inpatient Rehabilitation Facilities (IRFS) are required to report.
Which units within these facilities must report information?
The following units are to provide the necessary information:
- Facility-wide, inpatient locations (excluding neonatal intensive care units, well baby nurseries, and well baby clinics)
- Emergency departments
- 24-hour Observation locations
- Long-term acute care facilities
- Inpatient rehabilitation facilities
What information must be reported?
All non-duplicate C. difficile-positive laboratory assays (Laboratory-identified (LabID) events) as defined in CDC/NHSN Multidrug-Resistant Organism (MDRO) protocol. Non-duplicate is defined as no previous positive within the last 14 days in the same physical location within the reporting facility.
For monthly denominator data, patient days, the number of admissions, and the number of emergency department/observation location encounters must be reported.
How should the information be reported?
Those who report must use the National Healthcare Safety Network (NHSN) software application.
For more information see the following links.
MDRO/CDI Forms – Numerator
MDRO/CDI Forms - Denominator