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Clostridioides difficile infection

Published on 09 April 2024

Clostridioides difficile (also known as Clostridium difficile, C. difficile or C. diff) is a bacterium that can enter the human gut, via contaminated hands or surfaces, and produce toxins leading to diarrhoea and other serious bowel conditions.

Older people and people with compromised immune systems are more vulnerable to Clostridioides difficile infection (CDI), particularly following a course of antibiotics that has disrupted their normal balance of gut bacteria. While CDI is mainly associated with the healthcare setting, there's also a significant impact in the community.

National mandatory CDI surveillance started in 2006 for patients aged 65 years and older then was extended in April 2009 to include all patients from the age of 15 years old. There has been a dramatic decrease in CDI incidence rates in Scotland since 2008, though the disease remains a serious cause of ill health, especially in hospitalised and vulnerable patients.


Quarterly epidemiological data commentaries

Read the latest commentary on quarterly epidemiological data in Scotland:

Quarterly epidemiological data on Clostridioides difficile infection, Escherichia coli bacteraemia, Staphylococcus aureus bacteraemia and Surgical Site Infection in Scotland. October to December (Q4) 2023.

View all previous quarterly epidemiological commentaries.

View the Open Data for this report.

Annual surveillance of healthcare associated infection reports

Read the latest Healthcare Associated Infection annual report below:

ARHAI Scotland 2022 Annual Report

View all previous annual surveillance of healthcare associated infection report.

Annual antimicrobial use and resistance in humans reports

Read the latest Antimicrobial Use and Resistance in Humans report:

Scottish One Health Antimicrobial Use and Antimicrobial Resistance in 2022.

View all previous annual antimicrobial use and resistance in humans reports.


Read SHPN's guidance on Prevention and Control of Clostridioides difficile Infection (CDI) in Health and Social Care Settings in Scotland No 6 2017 edition.

Read our leaflet Clostridioides difficile infection - information for people who are getting care, their visitors, and anyone else who is in a healthcare setting.

Read SAPG's updated advice on on Clostridioides difficile (C.diff) Infection (CDI).


Read our Protocol for the Scottish Surveillance Programme for Clostridioides difficile infection.

Read our recommended protocol for testing for Clostridioides difficile and subsequent culture.

Read our protocol for the Clostridioides difficle snapshot programme.

Infection prevention and control

For infection prevention and control guidance visit the A-Z pathogens section of the National Infection and Prevention Control Manual.