‘European approach to combat outbreaks of Clostridium difficile associated diarrhoea by development of new diagnostic tests’
Project acronym: EACCAD
Contract:
LSHE-CT-2006-037870

Executive summary 
Summary description of project objectives
Clostridium difficile-infection (CDI) has become the most frequent nosocomial infection in many European hospitals, exceeding infections caused by MRSA. Its impact is considerable, both in terms of human suffering and costs of disease management. A number of factors have contributed to this escalation. On the one hand, the proportion of the European population in the principal high-risk group, the elderly, is rapidly rising. On the other hand, there has been a steady increase in strains exhibiting increased virulence and/or enhanced antibiotic resistance. In 2004, the situation was exacerbated by the arrival in Europe of a new hypervirulent strain (PCR ribotype 027) previously confined to N. America, where it has been responsible for a massive increase in CDI incidence and associated deaths. At May 2006, this new emerging strain has been recognized in UK (75 hospitals), The Netherlands (15 hospitals) Belgium (8 hospitals) and France (1 hospital). It is imperative that an overall European strategy to combat this and similar novel variants is devised.
Central to the control of epidemics are the deployment of assays able to rapidly diagnose and monitor the presence and spread of the organism. No such tests currently exist for these new hypervirulent C. difficile strains. It is the overall objective of this project is to develop the urgently required rapid, diagnostic assays.
Our objective will be achieved through the complementary skills of a consortium composed of 3 SMEs and 4 public sector institutes, each expert in their fields. Suitable diagnostic markers (DNA- and antigen-based) will be identified using a combination of targeted approaches (focusing on toxin and antibiotic resistance determinants), and empirical approaches (DNA arrays and HT-AFLP) to identify unique strain differences. Assay development will be led by the SMEs, using proprietary technologies. Clinical validation will be performed in a certificated reference laboratory. The programme outputs will allow the formulation of a European strategy to combat the considerable threat now being posed to European quality of life by C. difficile.

List of participants

Participant no.	Participant organization	Participant organization short name	Scientific team leader	Town	Country	
1	Department of Medical
Microbiology, Leiden
University Medical Center	LUMC	Dr. Ed Kuijper	Leiden	Netherlands	
2	University of Maribor Faculty of medicine	MFMB	Prof. Maja Rupnik	Maribor	Slovenia	
3	University of Nottingham	UNOTT	Prof. Nigel Minton	Nottingham	UK	
4	Istituto Superiore di Sanità	ISS	Dr. Paola Mastrantonio	Rome	Italy	
5	SME: TGC Biomics	TGC	Prof. Christoph von EichelStreiber	Mainz	Germany	
6	SME: Coris, BioConcept	Coris	Dr. Thierry Leclipteux	Gembloux	Belgium	
7	SME: Pathofinder	Patho	Dr. Guus Simons	Maastricht	Netherlands