Characteristics
Morphology
A gram positive rod that is anaerobic, motile, capable of producing subterminal spores, and produces a cytotoxin and enterotoxin.
Growth Conditions
Defined amino acid growth medium
Health Hazards
Host Range
Humans and Animals
Modes of Transmission
Fecal-oral contact; evidence for transmission via fomites and hands exists.
Signs and Symptoms 
Mild or moderate diarrhea, pseudomembranous colitis, may be associated with the passage of mucus or occult blood in stool, fever, cramping abdominal discomfort and peripheral leukocytosis are common but found in fewer than half the patients.
Infectious Dose Unknown.
Incubation Period 
Unknown.
Medical Precautions/Treatment
Prophylaxis None.
Vaccines None.
Treatment
Antibiotic therapy (Oral therapy with metronidazole or vancomycin.
Surveillance
Diagnosed by PCR. Monitor for symptoms (loose stool). Recover C. difficile organisms and/or toxin from stool samples to confirm.
MSU Requirements Report any exposures.
Laboratory Hazards
Laboratory Acquired Infections (LAIs)
One reported case of an LAI from C. difficile.
 Sources
Clinical specimens (feces).
Supplemental References
BMBL:5th Edition http://www.cdc.gov/biosafety/publications/bmbl5/BMBL.pdf
Canadian MSDS
http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/index-eng.php
CDC
Containment Requirements
BSL2 For all procedures involving known or potentially infected cultures.
ABSL2 For all procedures utilizing infected animals.
Spill Procedures
Small Notify others working in the lab. Remove and don new PPE. Cover area of the spill with absorbent material and add 10 % Bleach. Allow 30 minutes hour of contact time. After 30 minutes and then cleanup and dispose of materials.
Large For assistance, contact MSU's Biosafety Officer: Ryan Bartlett, ryan.bartlett@montana.edu, (406) 994-6821
or Safety and Risk Management (406-994- 2711).
Exposure Procedures
Mucous membrane
Flush eyes, mouth or nose for 5 minutes at eyewash station.
Other Exposures
Wash area with soap and water for 5 minutes.
Reporting
Immediately report incident to supervisor, complete a first report of injury report, and submit to Safety and Risk Management.
Medical Follow-up
During business hours: Bridger Occupational Health 3406 Laramie Drive. Weekdays 8am -6pm.  Weekends 9am-5pm
After business hours: Bozeman Deaconess Hospital Emergency Room 915 Highland Blvd Bozeman, MT
Viability
Disinfection
Spores are fairly resistant; moderate susceptiblity to 10 % Bleach; susceptible to high leve disinfectants (>2 % gluteraldehyde) with prolonged contact time.
Inactivation
Spores are inactivated by moist heat (15 minutes at 121oC) and dry heat (1 hour at 160-170oC).
Survival Outside Host
Spores can survive for long periods outside of host.
Personal Protective Equipment (PPE)
Minimum PPE Requirements
At minimum, gloves, closed toed shoes, lab coat, and appropriate face and eye protection prior to working with C. difficile. Additional PPE may be required depending on lab specific SOPs.
Additional Precautions
Wash hands with soap and water after removing gloves. Alcohol hand cleansers will not effectively eliminate the spores.