Continuing Importance of Laboratory-Acquired Infections

Pike, Robert M.; Sulkin, S. Edward; Schulze, Margaret

doi:10.2105/ajph.55.2.190

Cited by 78 publications

(41 citation statements)

References 21 publications

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“…In contrast to other bacterial aerosol-transmitted diseases, however, laboratory diphtheria infections seem to be considerably less frequent even in an era of markedly higher diphtheria prevalence than today: between 1930 and 1950, 15 diphtheria cases among laboratory staff were observed in the United States, while 224 cases of brucellosis, 153 of tuberculosis or 65 of tularaemia were reported, respectively (Pike et al 1965). Also, in a review of published and unpublished cases of laboratory infections until 1974, laboratory-acquired diphtheria only ranked as fourth of primarily aerosol-transmitted laboratory infections worldwide (24 cases in the United States, 9 in other countries, with a case fatality rate of 0) (Pike 1976).…”

Section: Laboratory Safety Issuesmentioning

confidence: 87%

Detection Methods for Laboratory Diagnosis of Diphtheria

Berger

Hogardt

Konrad

et al. 2013

Corynebacterium Diphtheriae and Related Toxigenic Species

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Although diphtheria has to be diagnosed primarily on clinical symptoms, the rapid and reliable detection and identification of the potentially toxigenic Corynebacterium species, C. diphtheriae, C. ulcerans and C. pseudotuberculosis, is essential for the definite diagnosis and management of diphtheria with respect to both the individual patient and the public health measures to be undertaken. Laboratory confirmation of suspected diphtheria has to aim for the isolation of the etiologic pathogen (including species identification and antibiotic susceptibility testing) as well as for differentiation of toxigenic from non-toxigenic strains (by using tox gene detection and toxigenicity testing). The recent introduction of the Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) into the microbiological algorithm of laboratory diagnosis of diphtheria allows the specific and escalating identification of the three potentially toxigenic Corynebacterium species from growing colonies. Finally, molecular typing techniques may be applied to explore the clonal relatedness of clinical isolates and their potential routes of transmission. The most relevant laboratory procedures fulfilling these requirements (microbiological culture, conventional biochemical tests, molecular methods for species identification and toxigenicity testing) will be presented here.

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Section: Laboratory Safety Issuesmentioning

confidence: 87%

Detection Methods for Laboratory Diagnosis of Diphtheria

Berger

Hogardt

Konrad

et al. 2013

Corynebacterium Diphtheriae and Related Toxigenic Species

View full text Add to dashboard Cite

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“…Recognizable accidents accounted for 215 (16%) of the infections, and the probable cause of the remaining 84% was believed to have been exposure to or ingestion of accidentally formed microbial aerosols. In 1965, Pike et al (165) updated their 1951 report with data accumulated from countries outside the United States and added 641 new or previously unreported laboratory-acquired infections. In 1967, Hanson et al (73) reported 428 laboratory-acquired infections with arboviruses, with the causal factor of most of the infections believed to have been exposure to infectious aerosols.…”

Section: Laboratory-acquired Infections Historical Perspectivementioning

confidence: 99%

“…Vesley and Hartmann (212) 165 clinical laboratories in Minnesota, with response rates of 79.6% from health departments and 90.3% from state clinical laboratories. The health departments reported no laboratory-acquired infections, and the clinical laboratories reported an incidence of 0.5 infection per 1,000 employees who worked directly with microorganisms.…”

Section: Laboratory-acquired Infections Historical Perspectivementioning

confidence: 99%

Biological safety cabinetry

Kruse¹,

Puckett²,

Richardson³

1991

Clin Microbiol Rev

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The biological safety cabinet is the one piece of laboratory and pharmacy equipment that provides protection for personnel, the product, and the environment. Through the history of laboratory-acquired infections from the earliest published case to the emergence of hepatitis B and AIDS, the need for health care worker protection is described. A brief description with design, construction, function, and production capabilities is provided for class I and class III safety cabinets. The development of the high-efficiency particulate air filter provided the impetus for clean room technology, from which evolved the class II laminar flow biological safety cabinet. The clean room concept was advanced when the horizontal airflow clean bench was manufactured; it became popular in pharmacies for preparing intravenous solutions because the product was protected. However, as with infectious microorganisms and laboratory workers, individual sensitization to antibiotics and the advent of hazardous antineoplastic agents changed the thinking of pharmacists and nurses, and they began to use the class II safety cabinet to prevent adverse personnel reactions to the drugs. How the class II safety cabinet became the mainstay in laboratories and pharmacies is described, and insight is provided into the formulation of National Sanitation Foundation standard number 49 and its revisions. The working operations of a class II cabinet are described, as are the variations of the four types with regard to design, function, air velocity profiles, and the use of toxins. The main certification procedures are explained, with examples of improper or incorrect certifications. The required levels of containment for microorganisms are given. Instructions for decontaminating the class II biological safety cabinet of infectious agents are provided; unfortunately, there is no method for decontaminating the cabinet of antineoplastic agents.

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“…Nevertheless, it has become fashionable, among non.. microbiologists and financial overlords, to discount as anecdotal the surveys and accounts of laboratory-acquired infection by Sulkin andPike (1951)~Sulkin (1961), Pike, Sulkin and Schulze (1965); Pike (1976Pike ( t 1978Pike ( , 1979 as well as the more restricted reports of Reid (1957), Harrington and Shannon (1976) series by Grist (1975-83). Indeed, Grist's figures, which show a dramatic decline in the incidence of hepatitis B among laboratory workers (especially biochemists and haematologists, who are most at risk)~have been used as 'evidence' that all other laboratory-acquired infections have declined to the point that microbiological safety, as required by the Howie Code, is not cost effective (Cohen, 1982).…”

Section: History Of Laboratory-acquired Infectionsmentioning

confidence: 99%

Safety in Microbiology: a Review

1984

Biotechnology and Genetic Engineering Reviews

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Continuing Importance of Laboratory-Acquired Infections

Abstract: This report summarizes the laboratory infections which have come to the attention of the authors since 1950. As a result they are able to picture the current extent of this continuing problem. The findings are related to trends in research and to interest in certain agents.

Cited by 78 publications

References 21 publications

Detection Methods for Laboratory Diagnosis of Diphtheria

Detection Methods for Laboratory Diagnosis of Diphtheria

Biological safety cabinetry

Safety in Microbiology: a Review

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