Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare (THL), Helsinki, Finland.
J Hosp Infect. 2013 Feb;83(2):127-31. doi: 10.1016/j.jhin.2012.09.021. Epub 2012 Nov 30.
In January 2008, laboratory-based surveillance of Clostridium difficile was initiated as a part of the Finnish National Infectious Disease Register (NIDR) and enhanced surveillance of hospitalized patients with C. difficile-associated infections (CDI) by the Finnish Hospital Infection Programme (SIRO).
To present data from the first three years.
All laboratories reported C. difficile findings positive for toxin production from stools to NIDR. Surveillance of hospitalized patients with CDI was conducted using the interim case definitions of the European Centre for Disease Prevention and Control for CDI, origin and severe case of CDI. In all, 16 acute care hospitals from 10 of the 21 healthcare districts (HDs) participated in SIRO during 2008-2010. Clinical microbiology laboratories were asked to send isolates from severe cases and persistent outbreaks to the national reference laboratory for genotyping.
The annual incidence rate of CDIs decreased by 24%, from 119 per 100,000 population in 2008 to 90 per 100,000 in 2010. The decrease occurred in 13/21 (62%) HDs (range of decrease by HD: 2-51%). The nosocomial rate decreased 26%, from 0.31 to 0.23 per 1000 patient-days, and occurred in about half of the hospitals that participated in SIRO. During 2008-2010, 17 HDs sent C. difficile specimens for typing. Ribotype 027 was found in eight HDs, all showing values above the mean or increasing population-based incidence rates of CDIs.
Population-based surveillance of CDIs and enhanced surveillance of nosocomial cases showed reduction in CDIs, but success in controlling the disease varied between regions.
2008 年 1 月，作为芬兰国家传染病登记处（NIDR）的一部分，启动了基于实验室的艰难梭菌监测，并通过芬兰医院感染计划（SIRO）加强了对艰难梭菌相关感染（CDI）住院患者的监测。
介绍前三年的数据。
所有实验室均向 NIDR 报告了从粪便中检测到产毒艰难梭菌的发现。通过欧洲疾病预防与控制中心的 CDI 临时病例定义、CDI 的起源和严重病例对住院患者进行 CDI 监测。在 2008 年至 2010 年期间，共有来自 21 个卫生区（HD）中的 10 个的 16 家急症护理医院参与了 SIRO。临床微生物学实验室被要求将严重病例和持续爆发的分离株送往国家参考实验室进行基因分型。
CDI 的年发病率下降了 24%，从 2008 年的每 10 万人 119 例降至 2010 年的每 10 万人 90 例。下降发生在 21 个 HD 中的 13 个（HD 下降范围为 2-51%）。医院获得性发病率下降了 26%，从每 1000 个患者日的 0.31 例降至 0.23 例，且发生在参与 SIRO 的半数以上医院。在 2008 年至 2010 年期间，有 17 个 HD 为基因分型送检了艰难梭菌标本。在 8 个 HD 中发现了 027 型核糖型，所有这些 HD 的值均高于平均值或 CDI 的基于人群的发病率呈上升趋势。
基于人群的 CDI 监测和对医院获得性病例的强化监测显示 CDI 有所减少，但疾病控制的成功程度在不同地区有所不同。
