NAME: Staphylococcus aureus
SYNONYM OR CROSS REFERENCE: Staphylococcal diseases, impetigo, toxic shock syndrome, food poisoning, intoxication
CHARACTERISTICS: Gram positive cocci, usually in clusters; coagulase positive; non-spore forming; non-motile; many strains produce exotoxins including staphylococcal enterotoxins A,B,C,D,E, toxic shock syndrome toxin (TSST-1) and exfoliative toxins A, and B
PATHOGENICITY: Opportunistic pathogen, normal flora; produces a variety of syndromes with a range of clinical manifestations; clinically different in general community, newborns, menstruating women, and hospitalized patients; food intoxication is characterized by abrupt/violent onset, severe nausea, cramps, vomiting, and diarrhea using lasting 1-2days; animal bites can result in localized infections; may cause surface or deep/system infections in both community and hospital settings; surface infections include impetigo, folliculitis, abscesses, boils, infected lacerations; deep infections include endocarditis, meningitis, septic arthritis, pneumonia, osteomyelitis; systemic infection may cause fever, headache malaise, myalgia; newborns are susceptible to scalded skin syndrome (SSS) caused by exfoliative toxins; my be colonized during delivery resulting in sepsis meningitis; toxic shock syndrome is an acute multi-system illness caused by TSST-1 a super antigen; characterized by sudden onset, high fever, vomiting, profuse watery diarrhea, myalgia, hypotension erythematous rash
EPIDEMIOLOGY: Occurs worldwide; particularly in areas where personal hygiene is suboptimal; in hospitals by development of antibiotic-resistant strains
HOST RANGE: Humans; to a lesser extent, warm-blooded animals
INFECTIOUS DOSE: Virulence of strains varies greatly
MODE OF TRANSMISSION: Contact with nasal carriers (30-40% of population); from draining lesions or purulent discharges; spread person-to-person; ingestion of food containing staphylococcal enterotoxin (food may be contaminated by food handlers hands); from mother to neonate during delivery
INCUBATION PERIOD: Variable and indefinite, commonly 4-10 days; disease may not occur until several months after colonization; interval between eating food and onset of symptoms is usually 2-4 hours (30 min to 8 hours)
COMMUNICABILITY: As long as purulent lesions continue to drain or carrier state persists; auto-infection may continue for the period of nasal colonization or duration of active lesions
RESERVOIR: Human; patients with indwelling catheters or IVs act as reservoirs for nosocomial infections; food borne - occasionally cows with infected udders
ZOONOSIS: Yes - direct or indirect contact with infected animals
VECTORS: None
DRUG SUSCEPTIBILITY: Many strains are multi-resistant to antibiotics and are of increasing importance; methicillin resistant (MRSA) strains have caused major outbreaks world-wide; Vancomycin resistant (VRSA) are being increasingly isolated; sensitivity must be determined for each strain
SUSCEPTIBILITY TO DISINFECTANTS: Susceptible to many disinfectants - 1% sodium hypochlorite, iodine/alcohol solutions, glutaraldehyde, formaldehyde
PHYSICAL INACTIVATION: Organisms are destroyed by heat (moist heat - 121° C for at least 15 min, dry heat - 160-170° C for at least 1 hour; enterotoxins are heat resistant, stable at boiling temperature
SURVIVAL OUTSIDE HOST: Carcass and organs - up to 42 days; floor - less than 7 days; glass - 46 hours; sunlight - 17 hours; UV - 7 hours; meat products - 60 days; coins - up to 7 days; skin from 30 min to 38 days
SURVEILLANCE: Monitor for skin inflammation if wounded by a sharp instrument; isolation of organism from wound or blood, CSF, urine; isolation of> 105 organisms or enterotoxin from suspected food
FIRST AID/TREATMENT: Fluid replacement for food poisoning; in localized skin infections, drain abscesses; antibiotic therapy for severe infections
IMMUNIZATION: None
PROPHYLAXIS: None
LABORATORY-ACQUIRED INFECTIONS: 29 reported cases up to 1973 with 1 death
SOURCES/SPECIMENS: Clinical specimens - blood, abcesses, lesion exudates, CSF, respiratory specimens, feces, urine
PRIMARY HAZARDS: Injuries from contaminated sharp instruments; ingestion; aerosols
SPECIAL HAZARDS: Direct contact with open cuts and lesions of skin
CONTAINMENT REQUIREMENTS: Biosafety level 2 practices, containment equipment and facilities for activities with cultures or potentially infectious clinical materials
PROTECTIVE CLOTHING: Laboratory coat: gloves when skin contact is unavoidable
OTHER PRECAUTIONS: Thorough handwashing before leaving the laboratory and after handling infectious materials
SPILLS: Allow aerosols to settle; wear protective clothing; gently cover spill with paper towel and apply 1% sodium hypochlorite, starting at perimeter and working towards the centre; allow sufficient contact time (30 min) before clean up
DISPOSAL: Decontaminate before disposal; steam sterilization, chemical disinfection
STORAGE: In sealed containers that are appropriately labelled
Date prepared: March, 2001
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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