Laboratory-Associated Infections: Incidence, Fatalities, Causes, and Prevention

Pike, Robert M.

doi:10.1146/annurev.mi.33.100179.000353

Cited by 205 publications

(123 citation statements)

References 70 publications

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“…Only a few deaths from LAB have been reported in the literature; most occurred prior to the development of antimicrobial agents. This is consistent with other reviews of LAB (6,8,21); the case fatality rate for brucellosis is reportedly 1 to 2%, which usually occurs in chronic cases with endocarditis (1).…”

Section: Discussionsupporting

confidence: 91%

“…Brucellosis is a frequently reported laboratory-acquired infection (6)(7)(8)(9). Characteristics of the organism and the disease contribute to the associated risk in a laboratory setting.…”

mentioning

confidence: 99%

“…No national surveillance system specifically identifies laboratory-acquired cases (20); therefore, the annual incidence of brucellosis resulting from laboratory transmission is not known. A few reviews of laboratory-acquired infections have been published; however, these reviews do not describe exposures leading to laboratory-acquired brucellosis in detail (6,8,21).…”

mentioning

confidence: 99%

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A Literature Review of Laboratory-Acquired Brucellosis

et al. 2013

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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.

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Section: Discussionsupporting

confidence: 91%

“…Brucellosis is a frequently reported laboratory-acquired infection (6)(7)(8)(9). Characteristics of the organism and the disease contribute to the associated risk in a laboratory setting.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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A Literature Review of Laboratory-Acquired Brucellosis

et al. 2013

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“…7 His death was lamented in mentioned a W. Brebner as the first recorded B virus victim, but nothing further. 10 In 1985, Dr. Morris Schaeffer, Brebner's collaborator on his final paper, 6 briefly recalled the events of his death and the apparent influence on the work of Sabin (an intern at Bellevue Hospital at the time of Brebner's death).…”

Section: 5mentioning

confidence: 99%

Herpes B virus -- "B" is for Brebner: Dr. William Bartlet Brebner (1903-1932)

Pimentel¹

2008

Canadian Medical Association Journal

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“…25 The most frequent cause of laboratoryassociated infections is probably the inhalation of an infectious aerosol. 26 Two recent studies have investigated the role of surgical power tools in the production of aerosols. 25,27 One of these, a study of aerosols generated at human autopsy, noted a peak concentration of respirable particles of 5700 particles/cc, when a Stryker saw was used to remove the skull cap of a young male.…”

Section: B Sulfur Dioxidementioning

confidence: 99%

Health hazard evaluation report: HETA-91-287-2228, Ohio Department of Agriculture, Reynoldsburg Laboratory, Reynoldsburg, Ohio.

1992

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This Health Hazard Evaluation (HHE) report and any recommendations made herein are for the specific facility evaluated and may not be universally applicable. Any recommendations made are not to be considered as final statements of NIOSH policy or of any agency or individual involved.Additional HHE reports are available at http://www.cdc.gov/niosh/hhe/reports This Health Hazard Evaluation (HHE) report and any recommendations made herein are for the specific facility evaluated and may not be universally applicable. Any recommendations made are not to be considered as final statements of NIOSH policy or of any agency or individual involved.Additional HHE reports are available at http://www.cdc.gov/niosh/hhe/reports This Health Hazard Evaluation (HHE) report and any recommendations made herein are for the specific facility evaluated and may not be universally applicable. Any recommendations made are not to be considered as final statements of NIOSH policy or of any agency or individual involved. applicable. Any recommendations made are not to be considered as final statements of NIOSH policy or of any agency or individual involved.Additional HHE reports are available at http://www.cdc.gov/niosh/hhe/reports Analyses of samples for total particulates collected during necropsy did not reveal concentrations above the limit of detection of the method (LOD: 0.01 mg). The results of air sampling for respirable particulates produced during necropsy were inconclusive. NIOSH investigators did not return to perform additional sampling do to the fact that the results of sampling for total particulates indicated that sampling for respirable particulates would reveal even lower concentrations.The results of interviews and questionnaires revealed that 91% of the employees in Buildings 3, 4, and 6 participated in the survey. In addition, four maintenance employees requested to be included in the sample. Although the majority of laboratory employees reported ready access to gloves and disposable respirators, there was a great deal of variability in the use of this personal protective equipment. Similarly, there were inconsistencies in the storage locations for food and personal items, the wearing of lab coats or uniforms while eating, and the home laundering of work-specific clothing. Although 35% of the lab workers were aware of the classification of disease organisms according to biosafety level, only one employee reported having received any such training while working at the Reynoldsburg labs, and none of the employees could correctly identify the biosafety level of the organism or disease that they worked with the majority of the time.On the basis of the data obtained during this investigation, the NIOSH investigators determined that a potential hazard exists for the transmission of infectious organisms to laboratory workers in Building 6, due to the lack of a comprehensive biological safety program at the ODA Reynoldsburg labs. In addition, Building 3 requires extensive renovations to return laboratory ventilation systems to r...

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Laboratory-Associated Infections: Incidence, Fatalities, Causes, and Prevention

Cited by 205 publications

References 70 publications

A Literature Review of Laboratory-Acquired Brucellosis

A Literature Review of Laboratory-Acquired Brucellosis

Herpes B virus -- "B" is for Brebner: Dr. William Bartlet Brebner (1903-1932)

Health hazard evaluation report: HETA-91-287-2228, Ohio Department of Agriculture, Reynoldsburg Laboratory, Reynoldsburg, Ohio.

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