Clostridium difficile

Clostridium difficile

MATERIAL SAFETY DATA SHEET - INFECTIOUS SUBSTANCES

SECTION I - INFECTIOUS AGENT

NAME: Clostridium difficile

SYNONYM OR CROSS REFERENCE: N/A

CHARACTERISTICS: Gram positive rod, anaerobic, motile, subterminal spores, produces a cytotoxin and enterotoxin

SECTION II - HEALTH HAZARD

PATHOGENICITY: Opportunistic pathogen, broad-spectrum antibiotic therapy eliminates competing gut flora, allowing the overgrowth of C. difficile; important cause of antibiotic-associated diarrhea and pseudomembranous colitis; diarrhea in cancer patients receiving chemotherapy; symptoms range from mild diarrhea to severe colitis (possibly fatal)

EPIDEMIOLOGY: Worldwide; 2-3% of adults are asymptomatic carriers ; 50% of healthy neonates (<1 year old) are carriers; nosocomial transmission increasingly important

HOST RANGE: Humans and other animals

INFECTIOUS DOSE: Not known

MODE OF TRANSMISSION: Fecal-oral contact; evidence for transmission via fomites and hands exists

INCUBATION PERIOD: Not known

COMMUNICABILITY: May be transmitted from person to person

SECTION III - DISSEMINATION

RESERVOIR: Soil, water, hay, sand; intestinal tract of humans and other animals

ZOONOSIS: None

VECTORS: None

SECTION IV - VIABILITY

DRUG SUSCEPTIBILITY: Susceptible to metronidazole and vancomycin

DRUG RESISTANCE: Metronidazole and vancomycin-resistant strains have been reported

SUSCEPTIBILITY TO DISINFECTANTS: Spores are fairly resistant; moderate susceptibility to 1% sodium hypochlorite; susceptible to high level disinfectants (>2% glutaraldehyde) with prolonged contact time

PHYSICAL INACTIVATION: Spores are fairly resistant to heat (spores destroyed by moist heat - 121°C for at least 15 min)

SURVIVAL OUTSIDE HOST: Spores can survive for long periods outside of host

SECTION V - MEDICAL

SURVEILLANCE: Monitor for symptoms; recovery of C. difficile organisms and/or toxin from stool samples

FIRST AID/TREATMENT: Antibiotic therapy should be stopped; oral therapy with metronidazole or vancomycin

IMMUNIZATION: None

PROPHYLAXIS: None

SECTION VI - LABORATORY HAZARDS

LABORATORY-ACQUIRED INFECTIONS: 1 reported case of a laboratory-acquired infection from C. difficile

SOURCES/SPECIMENS: Clinical specimens - feces

PRIMARY HAZARDS: Injuries from contaminated sharp instruments

SPECIAL HAZARDS: Not known

SECTION VII - RECOMMENDED PRECAUTIONS

CONTAINMENT REQUIREMENTS: Biosafety level 2 practices, containment equipment and facilities for activities involving clinical specimens and cultures

PROTECTIVE CLOTHING: Laboratory coat; gloves when direct contact with infectious materials is unavoidable

OTHER PRECAUTIONS: None

SECTION VIII - HANDLING INFORMATION

SPILLS: Allow aerosols to settle; wear protective clothing; gently cover spill with paper towels and apply a suitable disinfectant (high level or 1% sodium hypochlorite), starting at perimeter and working towards the centre; allow sufficient contact time before clean up

DISPOSAL: Decontaminate before disposal; steam sterilization, chemical disinfection, incineration

STORAGE: In sealed containers that are appropriately labelled

SECTION IX - MISCELLANEOUS INFORMATION

Date prepared: January 2000

Prepared by: Office of Laboratory Security, PHAC

Although the information, opinions and recommendations contained in this Material Safety Data Sheet are compiled from sources believed to be reliable, we accept no responsibility for the accuracy, sufficiency, or reliability or for any loss or injury resulting from the use of the information. Newly discovered hazards are frequent and this information may not be completely up to date.

Copyright © Health Canada, 2001

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