A Literature Review of Laboratory-Acquired Brucellosis

Abstract

bBrucellosis is a bacterial zoonotic disease which has been associated with laboratory-acquired infections. No recent reviews have addressed the characteristics of laboratory-acquired brucellosis (LAB). English-language literature was reviewed to identify reports of laboratory exposures to Brucella spp. and LAB cases between 1982 and 2007. Evaluation of 28 case reports identified 167 potentially exposed laboratory workers, of whom 71 had LAB. Nine reports were identified that summarized an additional 186 cases of LAB. Only 18 (11%) exposures were due to laboratory accidents, 147 (88%) exposures were due to aerosolization of organisms during routine identification activities, and the circumstances of 2 (1%) exposures were unknown. Brucella melitensis was the causative agent in 80% (135/167) of the exposures. Workers with high-risk exposures were 9.3 times more likely to develop LAB than workers with low-risk exposures (95% confidence interval [CI], 3.0 to 38.6; P < 0.0001); they were also 0.009 times likelier to develop LAB if they took antimicrobial PEP than if they did not (95% CI, 0 to 0.042; P < 0.0001). The median incubation period in case and summary reports was 8 weeks (range 1 to 40 weeks). Antimicrobial PEP is effective in preventing LAB. The incubation period may be used to identify appropriate serological and symptom surveillance time frames for exposed laboratory workers.

Outbreak of laboratory-acquired Brucella abortus in Brazil: a case report

“…Transmission most likely occurred from an aerosol-generating event, as is commonly reported. However, contrary to most published accounts 3,4 , transmission was related to an accident, and no correlation with unsafe routine procedures could be established. No other reports of Brucella transmission associated with ventilation system failures were found.…”

“…in contexts in which animal infection occurs 1,2 , and numerous cases of brucellosis acquired in clinical or research laboratories have been reported 3,4 . However, no published accounts of laboratory-acquired brucellosis in Brazil were found in PubMed/Medline and Scielo searches up to the date of submission.…”

“…In laboratories, exposure occurs due to aerosolization, followed by inhalation, during routine identifi cation activities in 88% of cases, according to a recently published review 4 , but the bacterium can also be transmitted via direct contact 8,9,10 . Laboratory accidents, such as the breakage of centrifuge tubes or blood-culture vials, are not frequent and represent only 11% of cases 4 .…”

“…Laboratory accidents, such as the breakage of centrifuge tubes or blood-culture vials, are not frequent and represent only 11% of cases 4 . In most of the reported cases, exposure resulted from unsafe laboratory practices, such as working on an open bench with viable organisms; sniffi ng plates; not using protective equipment, such as gloves, masks and goggles; or ingesting suspensions of living Brucellae during mouth pipetting 3 .…”

Brucelosis: zoonosis de importancia en México

“…Debido a su capacidad de formar fácilmente aerosoles, se encuentra en la lista de bacterias, que pueden ser utilizadas en bioterrorismo, y debido a ello, en algunos países está restringido trabajar con Brucella, tanto en laboratorios clínicos, de investigación o en los que se realiza la producción de vacunas para animales 18,19 . De acuerdo con los Centros para el Control y Prevención de Enfermedades (CDC) de Atlanta, E.U.A., Brucella debe manipularse en laboratorios de bioseguridad nivel 3 y el personal que ahí labore deberá ser altamente capacitado 20 .…”