Using network analysis of hospitals to identify novel C difficile strains rapidly and efficiently, hence enabling prompt initiation of control efforts

Description of impact

Clostridioides difficile (“C Diff”) is a diarrhoea-causing bacteria that can lead to
hospitalisation and in some cases life-threatening sepsis. It is important to detect novel strains quickly so treatments and control can be adapted. Strains can be identified using gene sequencing, but laboratory capacity to do this is limited. This research informed the design of a new C. difficile surveillance programme for English hospitals, in which a small number of hospitals act as ‘sentinels’. These sentinel hospitals send specimens from patients with C. difficile infection, to the sequencing laboratory where they are checked for genetic evidence of new strains. UKHSA, in partnership with the
Heath Protection Research Unit at Oxford University, undertook a network analysis of patient connections between hospitals (using existing routinely-collected data) which was used in computer simulations of inter-hospital spread of a theoretical new strain. From these, we identified which combination of sentinels would deliver the quickest detection of
a novel strain - no matter where it first appears - and make best use of limited laboratory facilities. The network analysis is also being used to support response to hospital-based outbreaks of emerging strains of C. difficile (and other pathogens), enabling public health officials to alert other hospitals which have strong connections to the outbreak location, so proactive protective measures can be put in place in case of spread.

Impact date	Aug 2025