Clostridium difficile ribotype 027 is not evenly distributed in Hesse, Germany

• Clostridium difficile ribotype 027 is unevenly distributed in Hesse.
• Ribotype 027 has become the most common C. difficile strain in the Rhine-Main metropolitan area.
• Clinicians and infection control specialists should be aware of an increased risk of outbreaks by ribotype 027 in Germany.
• Establishment of a national surveillance program for CDI in combination with microbiological data is necessary for prevention of CDI in Germany.
• Timely availability of typing results is necessary for cluster investigation and identification of possible transmissions.

Clostridium difficile-isolates associated with CDI in different healthcare facilities in Hesse were analysed. The most common ribotypes were 001 (31.1%) and 027 (27.0%). The proportion of ribotype 027 among regional C. difficile-isolates was 10.8% in North Hesse, 17.2% in Middle Hesse, and 33.5% in the Rhine-Main Metropolitan Area. In the latter region, ribotype 027 was the most prevalent ribotype.