Clostridioides difficile infections - Annual Epidemiological Report for 2018−2020

This report presents surveillance data on Clostridioides (Clostridium) difficile infection (CDI) in acute care hospitals in European Union/European Economic Area (EU/EEA) countries, the UK, and Serbia. It includes previously unpublished data from 2018–2020 with a focus on data from 2020, and comparisons with previous years. Since the European Centre for Disease Prevention and Control (ECDC) began coordinating this surveillance on 1 January 2016, 26 countries/administrations have reported CDI data to the Centre, corresponding to 331 million patient-days.

In 2020, and 2021, ECDC did not issue a formal data call for CDI surveillance data, recognising the priority for national and EU responses to COVID-19 in the EU/EEA. As a result, fewer countries reported CDI data, especially case-based CDI data, for 2020 than for previous years. For 2018, 15 countries reported CDI data, for 2019, 13 countries reported and for 2020 eight countries reported. Therefore, year-on-year comparisons at EU/EEA level should be made with caution, and the reported surveillance data for 2020 have insufficient coverage to draw definitive conclusions on how the COVID-19 pandemic affected CDI in the EU/EEA.

Overall, data for a total of 1 798 hospital surveillance periods were reported by 17 countries for 2018−2020. For 2020, 736 hospital surveillance periods were reported by eight countries (Austria, Estonia, Germany, Hungary, Ireland, Lithuania, Portugal, and Slovenia), two of which (Germany and Portugal) submitted data for the first time. Germany provided the largest dataset (554 hospital surveillance periods,