NAME: Clostridium difficile
SYNONYM OR CROSS REFERENCE: N/A
CHARACTERISTICS: Gram positive rod, anaerobic, motile, subterminal spores, produces a cytotoxin and enterotoxin
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
RESERVOIR: Soil, water, hay, sand; intestinal tract of humans and other animals
ZOONOSIS: None
VECTORS: None
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
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
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
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
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
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