Biosafety of Microbiological Laboratories in Korea

Transcription

1 J Prev Med Public Health ;8():9 Biosafety of Microbiological Laboratories in Korea JinYong Lee, SangJun Eun, Kidong Park ), JongKyun Kim ), JeongSoo Im ), YooSung Hwang ), YongIk Kim Department of Health Policy and Management, Seoul National University College of Medicine; Division of Communicable Disease Control, Korea Center for Disease Control and Prevention ) ; Department of Preventive Medicine, Gachon Medical School ), Neodin Medical Institute ) Objectives : The biosafety level (BSL) practiced in microbiology laboratories in Korea according to the laboratory biosafety manual published by the World Health Organization (WHO) was evaluated using the data obtained by a survey. Methods : Under the advise of Clinical Laboratory Physicians, types of microorganisms were screened based on the guidelines of biosafety in microbiological and biomedical laboratories published by the US Center for Disease Control and Prevention and classified into risk groups. A questionnaire containing questions in areas was developed using the biosafety manual by published WHO. Of the,87 different organizations sent the survey, responded to the survey (response rate:.%). The species of microoganisms handled by as well as the biosafety level in microbiology laboratories were analyzed. Results : There were species of microorganisms handled in microbiology labs in Korea. The BSL required in microbiology labs was answered by the survey responders as the first grade in labs (.%), nd in 7 (8.%), rd in (8.%), and th in none. The average number of items satisfied was., showing only a 7.9% satisfactory rate and normal distribution. Conclusions : The state of overall observance of BSL in most microbiology labs of Korea was evaluated as lagging compared with the standard set up by WHO. Therefore, the Korean government need to produce and distribute a biosafety manual in microbiology laboratories and make efforts to prevent this threat through measures such as training in biosafety in microbiology labs. J Prev Med Public Health ;8():9 Key words : Safety, Laboratory Infection,,. (smallpox) [], (po lio) [].,,,,, (GMO, genetic modified organism), (biosafety) []. (biosafety),, [].,,,. (SARS) []., (LAI, laboratory associated infection) Kisaalt 9 [].,, [7]. [], [ ]

2 Table. Classification of pathogenic microorganesms according to risk group in this study Risk group (handling cultivation Bacteria Acinetobacter Actinobacilus Actinomyces pyogenes (C. pyogenes) Aeromonas hydrophila Amycolata autotrophica Archanobacterium haemolyticus (C. haemolyticus) Arizona hinshawii Bacillus anthracis Bartonella henselae, quintana, vinsonii Bordetella pertussis, etc Borrelia recurrentis, etc Brucella abortus, etc. Burkholderia cepacia, etc Campylobacter coli, etc. Chlamydia psittaci, etc. Clostridium botulinum, etc. Corynebacterium diphtheriae, etc. Coxiella burnetti (handling only) Dermatophila congolensis Edwardsiella tarda Erysipelothrix rhusiopathiae Escherichia coli Francisella tularensis (handling only) Haemophilus ducreyi, etc. Helicobacter pylori Klebsiella (except RG) Legionella pneumophila, etc. Leptospira interrogans Listeria Moraxella Mycobacterium tuberculosis Mycobacterium bovis (except BCG strain) Mycoplasma (except RG) Neisseria gonorrhoeae, etc. Nocardia asteroides, etc. other Mycobacterium Rhodococcus equi Salmonella Shigella Sphaerophorus necrophorus Staphylococcus aureus Streptococcus pneumoniae, etc. Treponema pallidum, etc. Vibrio cholerae, etc. Yersinia enterocolitica Fungus Blastomyces dermatitidis Cladosporium bantianum, etc. Coccidioides immitis (handling only) Cryptococcus neoformans Dactylaria galopava (Ochroconis gallopavum) Epidermophyton Exophiala (Wangiella) dermatitidis Fonsecaea pedrosoi Histoplasma capsulatum, etc. (handling only) Microsproum Paracoccidioides brasiliensis Penicillium marneffei Sporothrix schenckii Trichophyton Parasite Babesia divergens, etc. Cryptosporidium parvum, etc. Entamoeba histolytica Giardia lamblia, etc. Isospora Leishmania brasiliensis, etc. Microsporidium Naegleria fowleri Plasmodium Sarcocystis sui hominis, etc. Toxoplasma gondii, etc. Tripanosoma Cestoda Trematoda Nematoda Virus Acinetobacter Actinobacilus Actinomyces pyogenes (C. pyogenes) Aeromonas hydrophila Amycolata autotrophica Archanobacterium haemolyticus (C. haemolyticus) Arizona hinshawii Bacillus anthracis Bartonella henselae, quintana, vinsonii Bordetella pertussis, etc Borrelia recurrentis, etc Brucella abortus, etc. Burkholderia cepacia, etc Campylobacter coli, etc. Chlamydia psittaci, etc. Clostridium botulinum, etc. Corynebacterium diphtheriae, etc. Coxiella burnetti (handling only) Dermatophila congolensis Edwardsiella tarda Erysipelothrix rhusiopathiae Escherichia coli Francisella tularensis (handling only) Haemophilus ducreyi, etc. Helicobacter pylori Klebsiella (except RG) Legionella pneumophila, etc. Leptospira interrogans Listeria Moraxella Mycobacterium tuberculosis Mycobacterium bovis (except BCG strain) Mycoplasma (except RG) Neisseria gonorrhoeae, etc. Nocardia asteroides, etc. other Mycobacterium Rhodococcus equi Salmonella Shigella Sphaerophorus necrophorus Staphylococcus aureus Streptococcus pneumoniae, etc. Treponema pallidum, etc. Vibrio cholerae, etc. Yersinia enterocolitica Risk group (handling cultivation Bacteria other Bartonella Brucella abortus, etc. (cultivation and Burkholderia mallei, pseudomallei Coxiella burnetti. (cultivation and Francisella tularensis (cultivation and Pasteurella multocida type B Rickettsia Yersinia pestis Fungus Virus Coccidioides immitis (cultivation and Semliki Forest virus St. Louis encephalitis virus Venezuelan equine encephalo myelitis virus (except vaccine strain TC8) Flexal Risk group (handling cultivation Lymphocytic choriomeningitis virus (neurotropic strains) Hantaviruses (cultivation and Rift Valley fever virus other Japanese encephalitis virus Yellow fever virus Histoplasma capsulatum, etc. (cultivation and Herpesvirus simiae (cultivation and Monkeypox virus Prions HIV type and (cultivation and HTLV type and (cultivation and Simian immunodeficiency virus (cultivation and Vesicular stomatitis virus Virus Guanarito virus Lassa virus Junin virus Machupo virus Sabia virus CrimeanCongo hemorrhagic fever virus Ebola virus Marburg virus Absetterov virus Central European encephalitis virus Hanzalova virus Hypr virus Kumlinge virus Kyasanur Forest disease virus Omsk hemorrhagic fever virus Russian springsummer encephalitis virus Equine morbillivirus Hemorrhagic fever agents as yet undefined [7,8]. (WHO) (risk group), (BSL, biosafety level), [9], []., Lee Johnson [] , Kim Lee [] B 7,, 9,,, Cho [] 99

3 . Kim Lee [] 98. %,,,.,.,,,,,87..%.8%,,8.%,.9%, 9 7.%, 8.%. Table. The biosafety items used for estimating biosafety level Personal protective equipment Equipment for biosafety Structure of laboratory Management of laboratory Biosecurity Categories., 99 []. BMBL (biosafety in microbiological and biomedical laboratories).,,,,.,,,, 7, 8,,, 8, (Table ). Items Laboratory coveralls, gowns or uniforms Closedtoed footwear Safety glasses Face shields Masks Latex gloves Autoclaves Pipetting aids Loop incinerator Periodical decontamination of equipment Imperviousness to water and resistance to the organic solvents of bench tops Different lockers for protective laboratory clothing from those for street clothing. Hand washing sinks Biohazard warning symbol and sign Chemical disinfectants used in the case of spills of infectious materials Limited access to the laboratory when work with infectious agents Training in safety measures as an integral part of new employee's introduction to the laboratory Maintenance of adequate medical record for all personnel in case of need Continuing education for biosafety and biosecurity Written protocols or safety or operations manuals Laboratory's protocol for biosafety and biosecurity (laboratory biosafety manual) [9] Kim Lee [],.,,.,,,, (Table ).,,,,,,,,

4 ,,. A. (K index).,,... SPSS.K (ANOVA test) Turkey B. Table. Estimated biosafety lebels (BSL) of the microbiological laboratories investigated in this survey Estimated BSL by risk group Estimated BSL by organization itself Universities Hospitals Health centers Public organizations Private research centers Universities Hospitals Health centers Public organizations Private research centers Organization BSL BSL BSL BSL (%) (.) (.) (.) ( 8.) ( 9.) (.) (.) 9 (.) 7 (.) 7 (8.) 8 (9.) (.). 8,,,..,,, 7.,. 8 Bartonella, Brucella abortus, etc.( ), Burkholderia mallei, B. pseudomallei Coxiella burnetti(), Francisella tularensis( ), Rickettsia. Coccidioides immitis, Histoplasma capsulatum type B, Semliki Forest virus, St. Louis encephalitis virus, Venezuelan equine encephalomyelitis virus (except vaccine strain TC8), Hantaviruses( ), Japanese encephalitis virus, Yellow fever virus, Herpesvirus simiae( ), HIV type and ( ), HTLV type and ( ), Vesicular stomatitis virus (7.) 7 (8.) (9.8) (.) (8.9) 7 (8.) 9 (8.8) (9.8) 8 (.) (.8) (.) (.8) (.) 8 ( 9.) (.) (9.7) (.7) ( 8.) (.) 9 (.7) (7.) (7.9) (.) (.9),.%, 8.% 7 8.%..,. 9 (.%), (.8%), (.9%), 7(.%) (Table ).. 9.% K index.7 (:.8) (.) (.) (7.) (7.9) (.) 7 (.) (.) (.) (.) 7 (.) (.) (.) 9 (.) (.) (.) 8 (.) (.) (.)

5 Table. Kindex between the estimated BSL by risk group and the estimated BSL by organization itself Estimated BSL by organization itself BSL BSL BSL BSL (Table ).,, 9 (Table ).. 7.9%. Estimated BSL by risk group BSL BSL BSL BSL total index Table. The number of goodpractice items in each risk group Good practice items Mean SD * Turkey B test Estimated BSL of laboratories by risk group BSL BSL BSL.. a.. b (p<.) Standard error.8. ( : 8.8%),. ( : 7.%),.9 ( : 7.9%) (p<. by ANOVA test). Turkey B.,,.9.7 c 7 * : p<. by ANOVA test : significant difference between groups based on Turkey's multiple comparison test Cumulative percent (%) ,,.,,,,,..9%.,,,.9% 7.%.,,.9% 9.%. (biohazard sign),,.%.,,,,.% % (Table ).,,, 8,

6 Table. The number of goodpractice items(rate) at biosafely level(bsl) in each categorized organization Personal protective equipment Equipment for biosafety Structure of laboratory Management of laboratory Biosecurity., (.%), (.%), (8.8%), (biohazard sign) (.7%), (8.%). (.%), (.%), (8.%), (.9%), (8.%) % (Table 7). Category Universities (.9) (.) 9 (.) (.9) (.9) US,87. S * * : number of satisfied organizations : number of unsatisfied organizations N= (98.) 8 (.8) (.) (98.) (98.) Hospitals N= S US 9 (.7) 8 (.) 9 (9.) (.7) (.9) (9.) (.8) 8 (.7) (9.) (8.) Health centers N= S (.) 8 (.7) (.9) (.) (.) US (98.8) (.) (9.) (99.) (.) Public organizations N=9 S 8 (.) (.) (9.) (.8) (.) US (79.) (9.) (.) (87.) 8 (97.) Private research centers N= US N=.,,,.,..,,,.. Kim Lee [] 8.%, Sulkin Pike [7].8%.%. S (9.7) 8 (7.) (.) ( 7.) (.8) (8.) 8 (7.7) (.) (9.) (8.) S (.9) 7 (.9) (.9) (.) 7 (.) US (9.) (.) (9.) 7 (9.) (89.9)..,....% ( =.7)..,,.. 7.9% (Table ). Kim Lee.% [].....

7 Table 7. The number of goodpractice items(rate) according to the categorized biosafely items Category Personal protective equipment Equipment for biosafety Structure of laboratory Management of laboratory Biosecurity Items Laboratory coveralls, gowns or uniforms Closedtoed footwear Safety glasses Face shields Masks Latex gloves Autoclaves Pipetting aids Loop incinerator Periodical decontamination of equipment Imperviousness to water and resistance to the organic solvents of bench tops Different lockers for protective laboratory clothing from those for street clothing. Hand washing sinks Biohazard warning symbol and sign Chemical disinfectants used in the case of spills of infectious materials Limited access to the laboratory when work with infectious agents Training in safety measures as an integral part of new employee's introduction to the laboratory Maintenance of adequate medical record for all personnel in case of need Continuing education for biosafety and biosecurity Written protocols or safety or operations manuals Laboratory's protocol for biosafety and biosecurity University N= (98.) 9(7.) (.) 9(.) (8.7) (7.9) (9.) (9.) (8.) 9(.) (8.) (.) (9.) ( 7.7) (8.) (8.) (7.7) ( 7.7) (.) (9.) (.)...,, %. Hospital N= 9(98.) (7.) (.) 8(.) 9(77.9) 7(8.) 9(8.7) (.) 9(.8) 8(.) 77(7.) (7.) 8(9.) (.) 77(7.) (.) (.) (.) (.) 99(8.) (.) Health center N= 9(98.) 9(.) (.) (.7) 9(8.8) 8(.) 8(97.) (88.9) (89.) 9(7.9) (.) (7.7) (98.8) ( 7.) (8.9) (.) 8(7.) (.) (.) 8(.) (7.) Public organizatio ns N=9 9(.) ( 8.) (.) ( 8.) ( 89.7) ( 79.) 8( 97.) ( 87.) (.) (.) ( 89.7) ( 9.) 9(.) 8(.) ( 9.) (.9) 7(.) (.) 7( 7.9) 9( 7.) (.) Private research centers N= (.) ( 8.) ( 8.) 7(.8) ( 98.) ( 9.) ( 98.) 9( 89.) (.) ( 9.7) ( 9.9) ( 8.) 8( 87.9) 7(.) ( 9.) ( 8.8) ( 8.8) (.) (.) 8( 87.9) (.) N= (98.) (.) 8(.) 8(.) 7(8.8) (9.) (9.) (78.) 9(8.) 8(.) (7.8) 7(8.8) (9.) (.7) (8.) 9(8.) 8(.) (.9) (8.) 99(7.9) 7(8.).,,,.,,... (guideline). 98 HIV/AIDS.. 99 (biosecurity) (biosafety)..,,,, []., (GMO), (The Cartagena Protocol on Biosafety)., [8].

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