Department of Medical Microbiology, Leiden University Medical Centre, Leiden, the Netherlands.
Euro Surveill. 2016 Jul 21;21(29). doi: 10.2807/1560-7917.ES.2016.21.29.30292.
Suboptimal laboratory diagnostics for Clostridium difficile infection (CDI) impedes its surveillance and control across Europe. We evaluated changes in local laboratory CDI diagnostics and changes in national diagnostic and typing capacity for CDI during the European C. difficile Infection Surveillance Network (ECDIS-Net) project, through cross-sectional surveys in 33 European countries in 2011 and 2014. In 2011, 126 (61%) of a convenience sample of 206 laboratories in 31 countries completed a survey on local diagnostics. In 2014, 84 (67%) of these 126 laboratories in 26 countries completed a follow-up survey. Among laboratories that participated in both surveys, use of CDI diagnostics deemed 'optimal' or 'acceptable' increased from 19% to 46% and from 10% to 15%, respectively (p < 0.001). The survey of national capacity was completed by national coordinators of 31 and 32 countries in 2011 and 2014, respectively. Capacity for any C. difficile typing method increased from 22/31 countries in 2011 to 26/32 countries in 2014; for PCR ribotyping from 20/31 countries to 23/32 countries, and specifically for capillary PCR ribotyping from 7/31 countries to 16/32 countries. While our study indicates improved diagnostic capability and national capacity for capillary PCR ribotyping across European laboratories between 2011 and 2014, increased use of 'optimal' diagnostics should be promoted.
艰难梭菌感染（CDI）的实验室诊断效果不理想，这阻碍了其在全欧洲的监测和控制。我们通过 2011 年和 2014 年在 33 个欧洲国家进行的横断面调查，评估了欧洲艰难梭菌感染监测网络（ECDIS-Net）项目期间当地 CDI 诊断实验室的变化，以及 CDI 的国家诊断和分型能力的变化。在 2011 年，31 个国家的 206 个实验室中有 126 个（61%）便利样本实验室完成了一项关于当地诊断的调查。在 2014 年，这 126 个实验室中有 84 个（67%）在 26 个国家完成了后续调查。在参加了这两项调查的实验室中，被认为“最佳”或“可接受”的 CDI 诊断方法的使用从 19%增加到 46%和从 10%增加到 15%（p<0.001）。2011 年和 2014 年，31 个和 32 个国家的国家协调员分别完成了国家能力调查。任何艰难梭菌分型方法的能力从 2011 年的 22/31 个国家增加到 2014 年的 26/32 个国家；聚合酶链反应（PCR）核糖体分型的能力从 20/31 个国家增加到 23/32 个国家，特别是毛细管 PCR 核糖体分型的能力从 7/31 个国家增加到 16/32 个国家。虽然我们的研究表明，2011 年至 2014 年期间，欧洲实验室的诊断能力和毛细管 PCR 核糖体分型的国家能力有所提高，但应促进“最佳”诊断方法的广泛应用。
