Case review and coping strategies of laboratory-acquired infections of animal biosafety level-3/4 laboratories
[Significance]Laboratory-acquired infections(LAIs)are occupational infections caused by laboratory-related activities,which can lead to illness,disability,and even death of laboratory personnel.The personnel of(animal)biosafety level-3/4 laboratories((A)BSL-3/4)often face high risks and consequences of LAIs,and these infections may even have a major impact on public health and the environment.To reduce the chances of occurrence and impact of LAIs in(A)BSL-3/4 laboratories,this paper reviewed the literature on LAIs in(A)BSL-3/4 laboratories in China and abroad and the construction and management experience of(A)BSL-3/4 laboratories.The paper further analyzed the pathways and causes of LAIs and provided LAI prevention measures and post-exposure coping strategies for(A)BSL-3/4 laboratories.[Progress]The results showed that since 1978,there had been 12 reports in China and abroad of LAIs in(A)BSL-3/4 laboratories,21 reported infections and four deaths.Additionally,hundreds of non-laboratory personnel have been isolated and observed,causing public panic and serious economic losses.A total of eight highly pathogenic microorganisms(seven were zoonotic)caused the 12 cases of LAIs in(A)BSL-3/4 laboratories.Most of the LAIs were viral infections(n=7,87.50%),and only one case was a bacterial infection(n=1,12.50%).The most common highly pathogenic microorganisms that cause LAIs in(A)BSL-3/4 laboratories were Severe Acute Respiratory Syndrome Coronavirus(n=3,25.00%)and Ebola virus(n=3,25.00%).The main pathway leading to LAIs was needle-stick(n=6,50.00%),and the other pathways included improper management of bacteria and viruses,contact,splashing,and equipment damage.[Conclusions and Prospects]There are various sources of LAIs,and the most common routes of infection in the laboratories are inhalation of infectious aerosols,percutaneous inoculation(needle puncture,glass puncture,and/or animal bites or scratches),direct contact(skin and mucous membranes,etc.),and ingestion.Failure to comply with standard biosafety procedures is a major contributor to LAIs.Improper use of PPE and lack of respiratory personal protective equipment are common contributors to LAIs,and other factors include working with sharp implements,lack of hygiene practices,and inadequate training of personnel.Reducing the risks associated with LAIs is based on the use of existing technology,taking safety measures,using protective equipment,and training and assessment of laboratory personnel.(A)BSL-3/4 laboratories should adopt measures,such as establishing biosafety management systems and documents,strengthening personnel management,improving facilities and equipment management,disinfection and sterilization,to reduce the probability of LAI occurrence.Additionally,not all exposure events will cause LAIs.Key factors in determining whether exposure will cause LAIs and the severity of LAIs include the following:the biological characteristics of highly pathogenic microorganisms,exposure routes,emergency measures,such as washing/disinfection,and timely and effective prevention/treatment plans.Therefore,when there is an exposure event,(A)BSL-3/4 laboratories need to develop coping strategies,such as emergency response and reporting,safe transfer and isolation medical assessment,medical treatment,and prognosis assessment,to prevent escalation of the case.In conclusion,through continual research,construction and development of(A)BSL-3/4 laboratories will be improved,more comprehensive,and safer,and the probability and severity of LAIs will be greatly reduced.
(animal)biosafety level-3/4 laboratorieslaboratory-acquired infectionscase reviewprevention and coping strategies
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