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CAPNOCYTOPHAGA SPP.

PATHOGEN SAFETY DATA SHEET - INFECTIOUS SUBSTANCES

SECTION I - INFECTIOUS AGENT

NAME: Capnocytophaga spp.

SYNONYM OR CROSS REFERENCE: Capnocytophaga ochracea, Capnocytophaga canimorsus, Capnocytophaga cynodegmi, Capnocytophaga gingivalis, Capnocytophaga granulosa, Capnocytophaga haemolytica, Capnocytophaga leadbetteri, Capnocytophaga sputigena Footnote 1-Footnote 3.

CHARACTERISTICS: Capnocytophaga spp., of the family Flavobacteriaceae, are Gram-negative bacteria that appear as long facultative anaerobic rods that are 3-6 µm long. The slender fusiform bacilli are motile through gliding Footnote 2, Footnote 4-Footnote 6. Different morphology may be observed as curved filaments, coccoid, or spindle forms can exist Footnote 7. Strains are capnophlic (e.g. under 5%-10% CO2) and most strains grow well under strict anaerobic conditions. The colour of the colonies may vary from pink to yellowish Footnote 4, Footnote 6.

SECTION II - HAZARD IDENTIFICATION

PATHOGENICITY/TOXICITY: Capnocytophaga is an occasional pathogen found in oral diseases and brain abscesses Footnote 7, Footnote 8. It is a cause of systemic infections in immunocompromised patients, but can also cause disease in immunocompetent patients Footnote 2, Footnote 8. Most of the Capnocytophaga infections that have been reported were contiguous with the oropharynx, including periodontal diseases, ophthalmic lesions, respiratory tract infections, traumatic pericarditis, mediastinal or cervical abscesses, and peritonitis. Mucositis and lesions of the oral mucosal barrier provide a portal of entry for this organism, which can cause septicaemia, endocarditis, peripartum infections, pyonephrosis, osteomyelitis and septic arthritis Footnote 2.

C. canimorsus, which can be transmitted zoonotically, may cause sepsis and other severe infections (endocarditis, osteomyelitis, peritonitis) in immunocompromised patients and rarely in immunocompetent ones Footnote 7, Footnote 9. Patients who present within less than 8h to 12h after a dog bite may show local lesions without significant signs of local inflammation. Later, infection may present with localized cellulitis, pain at the site of injury, a purulent discharge, lymphangitis, and regional lymphadenopathy. Initial symptoms of septicemia may include fever, chills, myalgia, dyspnea, mental confusion, and headache. A fulminant and severe course can occur in immunocompromised persons, characterized by sepsis, meningitis, osteomylitis, peritonitis, endocarditis, pneumonia, purulent arthritis, disseminated intravascular coagulation (DIC) and fulminant purpura but has also been observed in previously healthy persons Footnote 7, Footnote 10.

EPIDEMIOLOGY: Capnocytophaga spp. is of worldwide prevalence Footnote 10. Since 1976, approximately 200 human cases of C. canimorsus infection have been reported worldwide Footnote 10.

HOST RANGE: Human, canines, cats, rabbits Footnote 7.

INFECTIOUS DOSE: Unknown.

MODE OF TRANSMISSION: C. canimorsus and C. cynodegmi are mainly associated with dog and cat bites or close animal contact Footnote 2, Footnote 7, Footnote 10.

INCUBATION PERIOD: The incubation period from the dog bite to the onset of systemic symptoms is about 5 days (range, 1 to 8 days, occasionally up to 30 days) Footnote 7, Footnote 10.

COMMUNICABILITY: Person-to-person transmission is very rare Footnote 10.

SECTION III - DISSEMINATION

RESERVOIR: C. ochracea, C. gingivalis, C. granulosa, C. haemolytica, C. sputigena and C. leadbetteri are normal inhabitants of the human oral cavity, and especially dental plaque Footnote 2-Footnote 4, Footnote 7. C. canimorsus and C. cynodegmi are part of the oral microbiota of canines and, more rarely, of cats and rabbits Footnote 7, Footnote 9.

ZOONOSIS: Transmission through bites, scratches, licks or simply exposure to dogs or cat infected with C. canimorsus and C. cynodegmi Footnote 7, Footnote 10.

VECTORS: None.

SECTION IV - STABILITY AND VIABILITY

DRUG SUSCEPTIBILITY: Capnocytophaga spp. are usually susceptible to macrolides, clindamycin, tetracycline, linezolid, chloramphenicol, imipenem and quinolones Footnote 7.

DRUG rESISTANCE: Capnocytophaga spp. are resistant to aminoglycosides Footnote 7, polymyxin, fusidic acid, fosfomycin, colimycin and trimethoprim Footnote 2.

SUSCEPTIBILITY TO DISINFECTANTS: Susceptable to antiseptic solutions of chlorhexidine or 1% povidone-iodine Footnote 2.

PHYSICAL INACTIVATION: No information specific to this species is available. However, similar organisms have been observed to be susceptible to moist heat (121°C for at least 15 min); dry heat (160-170°C for at least 1 hour); low temperature sterilization (i.e. Ethylene oxide Footnote 11, Footnote 12 or plasma sterilization Footnote 13, Footnote 14).

SURVIVAL OUTSIDE HOST: Unknown.

SECTION V – FIRST AID / MEDICAL

SURVEILLANCE: Monitor for symptoms. The diagnosis of Capnocytophaga spp. infection is usually made based on the bacterial culture of blood, other body fluids (cerebrospinal fluid) or less frequently from the bite wound or tissue from the bitten individual. The use of enriched media is important for the isolation of Capnocytophaga spp. The organism grows best at 35 to 37 ºC in an aerobic atmosphere plus 5 to 10 % CO2 or anaerobically Footnote 7, Footnote 10.

Note: All diagnostic methods are not necessarily available in all countries.

first AID/TREATMENT: Administer proper antibiotic therapy Footnote 2, Footnote 7. Therapy with amoxicillin-clavulanate should be initiated immediately when infection with C. canimorsus is suspected. This therapy must be particularly used for splenectomized or immunocompromised patients after a dog or a cat bite Footnote 7.

IMMUNIZATION: None.

PROPHYLAXIS: Cleaning any animal bite wound with an antiseptic, prophylactic treatment with antibiotic may be prescribed Footnote 10.

SECTION VI - LABORATORY HAZARDS

LABORATORY-ACQUIRED INFECTIONS: No cases have been reported.

SOURCES/SPECIMENS: Blood, cerebrospinal fluid, saliva samples from humans, dogs or cats Footnote 10.

PRIMARY HAZARDS: Accidental parenteral inoculation.

SPECIAL HAZARDS: Working with laboratory animals, particularly dogs Footnote 5, Footnote 10.

SECTION VII – EXPOSURE CONTROLS / PERSONAL PROTECTION

RISK GROUP CLASSIFICATION: Risk group 2. This risk group applies to the genus as a whole, and may not apply to every species within the genus.

CONTAINMENT REQUIREMENTS: Containment Level 2 facilities, equipment, and operational practices for work involving infected or potentially infected materials, animals, or cultures. These containment requirements apply to the genus as a whole, and may not apply to each species within the genus.

PROTECTIVE CLOTHING: Lab coat. Gloves when direct skin contact with infected materials or animals is unavoidable. Eye protection must be used where there is a known or potential risk of exposure to splashes Footnote 15.

OTHER PRECAUTIONS: All procedures that may produce aerosols, or involve high concentrations or large volumes should be conducted in a biological safety cabinet (BSC). The use of needles, syringes, and other sharp objects should be strictly limited. Additional precautions should be considered with work involving animals or large scale activities Footnote 15.

SECTION VIII – HANDLING AND STORAGE

SPILLS: Allow aerosols to settle and, wearing protective clothing, gently cover spill with paper towels and apply an appropriate disinfectant, starting at the perimeter and working towards the centre. Allow sufficient contact time before clean up Footnote 15.

DISPOSAL: Decontaminate all wastes that contain or have come in contact with the infectious organism before disposing by autoclave, chemical disinfection, gamma irradiation, or incineration Footnote 15.

STORAGE: The infectious agent should be stored in leak-proof containers that are appropriately labelled Footnote 15.

SECTION IX - REGULATORY AND OTHER INFORMATION

REGULATORY INFORMATION: The import, transport, and use of pathogens in Canada is regulated under many regulatory bodies, including the Public Health Agency of Canada, Health Canada, Canadian Food Inspection Agency, Environment Canada, and Transport Canada. Users are responsible for ensuring they are compliant with all relevant acts, regulations, guidelines, and standards.

UPDATED: December, 2011

PREPARED BY: Pathogen Regulation Directorate, Public Health Agency of Canada.

Although the information, opinions and recommendations contained in this Pathogen 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 ©
Public Health Agency of Canada, 2011
Canada

REFERENCES:

Footnote 1
Shah, H. N., Gharbia, S. E., & Duerden, B. I. (1998). Bacteroides, Prevotella and Porphyromonas. In L. Collier, A. Balows & M. Sussman (Eds.), Topley & Wilson's Microbiology and Microbial Infectionsm: Systematic Bacteriology (9th ed., pp. 1305-1330). London: Hodder Arnold Publication.

Footnote 2
Jolivet-Gougeon, A., Sixou, J. -., Tamanai-Shacoori, Z., & Bonnaure-Mallet, M. (2007). Antimicrobial treatment of Capnocytophaga infections. International Journal of Antimicrobial Agents, 29(4), 367-373.

Footnote 3
Frandsen, E. V., Poulsen, K., Kononen, E., & Kilian, M. (2008). Diversity of Capnocytophaga species in children and description of Capnocytophaga leadbetteri sp. nov. and Capnocytophaga genospecies AHN8471. International Journal of Systematic and Evolutionary Microbiology, 58(Pt 2), 324-336. doi:10.1099/ijs.0.65373-0

Footnote 4
Zinder, S. H. (1998). Bacterial Diversity. In L. Collier, A. Balows & M. Sussman (Eds.), Topley & Wilson's Microbiology and Microbial Infectionsm: Systematic Bacteriology (9th ed., pp. 125-147). London: Hodder Arnold Publication.

Footnote 5
Hofstad, T. (1998). Fusobacterium and Leptotrichia. In L. Collier, A. Balows & M. Sussman (Eds.), Topley & Wilson's Microbiology and Microbial Infectionsm: Systematic Bacteriology (9th ed., pp. 1355-1364). London: Hodder Arnold Publication.

Footnote 6
Forlenza, S. W. (1991). Capnocytophaga: An update. Clinical Microbiology Newsletter, 13(12), 89-91.

Footnote 7
Krauss, H., Weber, A., Appel, M., Enders, B., Isenberg, H. D., Schiefer, H. G., Slenczka, W., von Graevenitz, A., & Zahner, H. (2003). Bacterial Zoonoses. Zoonoses: Infectious Diseases Transmissible from Animals to Humans. (3rd ed., pp. 173-252). Washington, DC.: ASM press.

Footnote 8
Holt, S. C., & Leadbetter, E. R. (1998). Structure-function Relationships in Prokaryotic Cells. In L. Collier, A. Balows & M. Sussman (Eds.), Topley & Wilson's Microbiology and Microbial Infectionsm: Systematic Bacteriology (9th ed., pp. 11-44). London: Hodder Arnold Publication.

Footnote 9
Sandoe, J. A. T. (2004). Capnocytophaga canimorsus endocarditis. Journal of Medical Microbiology, 53(3), 245-248.

Footnote 10
Gaastra, W., & Lipman, L. J. A. (2010). Capnocytophaga canimorsus. Veterinary Microbiology, 140(3-4), 339-346.

Footnote 11
Wood, M. (1974). Ethylene oxide sterilization. RESP.THER., 4(1), 43-47+75.

Footnote 12
Rutala, W. A. (1996). APIC guideline for selection and use of disinfectants. American Journal of Infection Control, 24(4), 313-342.

Footnote 13
Moisan, M., Barbeau, J., Crevier, M. -., Pelletier, J., Philip, N., & Saoudi, B. (2002). Plasma sterilization. Methods and mechanisms. Pure and Applied Chemistry, 74(3), 349-358.

Footnote 14
Burnett, L. A. C., Lunn, G., & Coico, R. (2009). Biosafety: Guidelines for working with pathogenic and infectious microorganisms. Current Protocols in Microbiology, (SUPPL. 13), 1A.1.1-1A.1.14.

Footnote 15
Public Health Agency of Canada. (2004). In Best M., Graham M. L., Leitner R., Ouellette M. and Ugwu K. (Eds.), Laboratory Biosafety Guidelines (3rd ed.). Canada: Public Health Agency of Canada.