Ribotyping entry criteria: guidance to help NHS colleagues access the Clostridioides difficile ribotyping service
Updated 11 April 2024
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This publication is available at https://www.gov.uk/government/publications/clostridium-difficile-ribotyping-service-how-to-access/ribotyping-entry-criteria-guidance-to-help-nhs-colleagues-access-the-clostridioides-difficile-ribotyping-service
Investigation scope
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do you have a potential outbreak of C. difficile infection (CDI) in your hospital (that is, 2 or more cases of CDI linked in person, place and time)?
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do you have an increased frequency (or raised baseline rates of CDI)?
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do you have a potential problem with a hyper-virulent strain (that is, increases in CDI frequency, severity, mortality or relapse rate)?
Process
- do you have access to the original cytotoxin-positive faecal samples or C. difficile isolates for your investigation, to refer to the Clostridioides difficile ribotyping service (CDRN) for ribotyping?
Ribotyping can only be performed on pure cultures of C. difficile. Insufficient sample size may affect recovery. A minimum of 2 grams of faecal sample should be supplied.
- do you have access to the UK Health Security Agency (UKHSA) CDRN electronic requesting system (ERS) to request your testing?
Check in case a colleague in your hospital already has access to the ERS.
If not, contact laboratoryinformatics@ukhsa.gov.uk for support.
Limitations
Samples testing positive for C. difficile toxin genes only are strongly discouraged (there is an increased risk of culture-negativity associated with these samples).
Routine ribotyping of environmental isolates is not necessary (please do not request ribotyping on environmental isolates – these will not be processed).