1887

Abstract

Our aim was to prospectively manage 22 -exposed individuals and identify the lapses in laboratory practices that lead to the exposure. The exposed individuals were risk-stratified, assessed for post-exposure prophylaxis (PEP), counselled to self-monitor symptoms and followed-up with three serology tests. Staff laboratory practices were recorded. Ten out of 13 high-risk individuals received PEP within 48 h of exposure. Compliance with PEP and serology monitoring was 90 and 96 %, respectively. No brucellosis cases were documented. A single handler manipulated the isolate on the open bench. Movement of the isolate was tracked in detail, highlighting various points of laboratory non-conformance. Early PEP intervention is effective in preventing acquired brucellosis. Our pragmatic post-exposure management achieved high PEP and serology compliance. We experience first-hand how regular staff engagement motivated PEP adherence and interval blood sampling attendance. The enforcement of practical strategies and safety practices was also implemented without compromising our laboratory processing times.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.000772
2018-07-01
2024-03-28
Loading full text...

Full text loading...

/deliver/fulltext/jmm/67/7/1012.html?itemId=/content/journal/jmm/10.1099/jmm.0.000772&mimeType=html&fmt=ahah

References

  1. Versalovic J, Carroll KC, Funke G, Jorgensen JH, Landry ML et al. Manual of Clinical Microbiology, 10th ed. Washington, DC: ASM Press; 2011
    [Google Scholar]
  2. Traxler RM, Lehman MW, Bosserman EA, Guerra MA, Smith TL. A literature review of laboratory-acquired brucellosis. J Clin Microbiol 2013; 51:3055–3062 [View Article][PubMed]
    [Google Scholar]
  3. Jeffrey Griffiths JHM, Heggenhougen K, Quah SR. Public Health and Infectious Diseases, 1st ed. Elsevier; 2010
    [Google Scholar]
  4. Zamri-Saad M, Kamarudin MI. Control of animal brucellosis: the Malaysian experience. Asian Pac J Trop Med 2016; 9:1136–1140 [View Article][PubMed]
    [Google Scholar]
  5. Traxler RM, Guerra MA, Morrow MG, Haupt T, Morrison J et al. Review of brucellosis cases from laboratory exposures in the United States in 2008 to 2011 and improved strategies for disease prevention. J Clin Microbiol 2013; 51:3132–3136 [View Article][PubMed]
    [Google Scholar]
  6. Public Health England Management of laboratory exposure to Brucella species: assessing exposure and individual assessment flowchart. PHE publications gateway number: 2017218 edJuly 2017
  7. WAHIS World Animal Health Information Database, WAHIS Interface. Available from www.oie.int/wahis_2/public/wahid.php/Diseaseinformation/statusdetail [08/12/2017]
  8. Berger S. Brucellosis: Global Status GIDEON Informatics, Inc.; 2017 p. 33
    [Google Scholar]
  9. Seow CJ, Barkham T, Wong PM, Lin L, Pada SK et al. Brucellosis in a Singaporean with prolonged fever. Singapore Med J 2009; 50:e312-4[PubMed]
    [Google Scholar]
  10. Rudrik JT, Soehnlen MK, Perry MJ, Sullivan MM, Reiter-Kintz W et al. Safety and accuracy of matrix-assisted laser desorption ionization-time of flight mass spectrometry for identification of highly pathogenic organisms. J Clin Microbiol 2017; 55:3513–3529 [View Article][PubMed]
    [Google Scholar]
  11. Reddy S, Manuel R, Sheridan E, Sadler G, Patel S et al. Brucellosis in the UK: a risk to laboratory workers? recommendations for prevention and management of laboratory exposure. J Clin Pathol 2010; 63:90–92 [View Article][PubMed]
    [Google Scholar]
  12. Staszkiewicz J, Lewis CM, Colville J, Zervos M, Band J. Outbreak of Brucella melitensis among microbiology laboratory workers in a community hospital. J Clin Microbiol 1991; 29:287–290[PubMed]
    [Google Scholar]
  13. Bouza E, Sánchez-Carrillo C, Hernangómez S, González MJ. Laboratory-acquired brucellosis: a Spanish national survey. J Hosp Infect 2005; 61:80–83 [View Article][PubMed]
    [Google Scholar]
  14. Yagupsky P, Baron EJ. Laboratory exposures to brucellae and implications for bioterrorism. Emerg Infect Dis 2005; 11:1180–1185 [View Article][PubMed]
    [Google Scholar]
  15. Fiori PL, Mastrandrea S, Rappelli P, Cappuccinelli P. Brucella abortus infection acquired in microbiology laboratories. J Clin Microbiol 2000; 38:2005–2006[PubMed]
    [Google Scholar]
  16. Knudsen A, Kronborg G, Dahl Knudsen J, Lebech AM. Laboratory exposure to Brucella melitensis in Denmark: a prospective study. J Hosp Infect 2013; 85:237–239 [View Article][PubMed]
    [Google Scholar]
  17. Sam IC, Karunakaran R, Kamarulzaman A, Ponnampalavanar S, Syed Omar SF et al. A large exposure to Brucella melitensis in a diagnostic laboratory. J Hosp Infect 2012; 80:321–325 [View Article][PubMed]
    [Google Scholar]
  18. Castrodale LJ, Raczniak GA, Rudolph KM, Chikoyak L, Cox RS et al. A case-study of implementation of improved strategies for prevention of laboratory-acquired Brucellosis. Saf Health Work 2015; 6:353–356 [View Article][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.000772
Loading
/content/journal/jmm/10.1099/jmm.0.000772
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error