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Characteristics
Morphology
A gram positive rod that is anaerobic, motile, capable of producing subterminal spores, and produces a cytotoxin and enterotoxin.
Disease
Antibiotic - associated diarrhea, pseudomembranous colitis (PMC).
Zoonosis
Potential zoonosis. Moreover, contaminated food can cause infection. 
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 available.
Vaccines None available. 
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). Cultures, frozen stocks, other samples described in IBC protocol.
Supplemental References
Canadian MSDS: http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/index-eng.php
BMBL
 https://www.cdc.gov/labs/BMBL.html 
CDC
NIH Guidelines
Risk Group & Containment Requirements
Risk Group 2

Agents that are associated with human disease which is rarely serious and for which preventive or therapeutic interventions are often available.
BSL2
For all procedures involving suspected or known infectious specimen or cultures.
ABSL2
For all procedures utilizing infected animals.
Spill Procedures
Small
Notify others working in the lab. Remove PPE and don new PPE. Cover area of the spill with absorbent material and add fresh 1:10 bleach:water. Allow 20 munutes (or as directed) of contact time. After 20 minutes, cleanup and dispose of materials.
Large
  • Immediately notify all personnel in the lab and clear all personnel from the area. Remove any contaminated PPE/clothing and leave the lab. 
  • Secure the area by locking doors, posting signage and guarding the area to keep people out of the space. 
For assistance, contact MSU's Biosafety Officer (406-994-6733) 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 form, 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 susceptible to 1:10 bleach:water for 20 minutes; susceptible to >2% gluteraldehyde with minimum of 20 minutes contact time, accelerated hydrogen peroxide
Inactivation
Inactivated by moist heat (121oC for 30 minutes)
Survival Outside Host

Can survive in soil, meat, and vegetables. Spores can survive for long periods outside of host.
Personal Protective Equipment (PPE)
Minimum PPE Requirements
Lab coat, disposable gloves, safety glasses, closed toed shoes, long pants
Additional Precautions
 Additioanl PPE may be required depending on lab specific SOPs and IBC Protocol.