An accidental laboratory exposure toBrucella melitensis: the prospective post‐exposure management and a detailed investigation into the nature of the exposure. Issue 7 (July 2018)

• Record Type: Journal Article
• Authors: Wong, C.; Ng, S. Y.; Tan, S. H.
• Is Part Of: Journal of medical microbiology. Volume 67:Issue 7(2018)
• Publication Date: 2018-07
• Subjects: Brucellosis -- Brucella exposure -- laboratory‐acquired infection -- accidental laboratory exposure -- post‐exposure prophylaxis; Medical microbiology -- Periodicals; 616.9041
• DOI: 10.1099/jmm.0.000772
• Languages: English
• ISSNs: 0022-2615

Abstract

Abstract : N/A: Our aim was to prospectively manage 22 Brucella ‐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 Brucella 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.