van Soolingen D, Wisselink H J, Lumb R, Anthony R, van der Zanden A, Gilpin C
<label>*</label>Tuberculosis Reference Laboratory, National Institute for Public Health and the Environment (RIVM), Bilthoven.
<label><sup>‡</sup></label>Central Veterinary Institute of Wageningen, Lelystad, The Netherlands.
Int J Tuberc Lung Dis. 2014 Aug;18(8):885-9. doi: 10.5588/ijtld.13.0629.
In industrialised countries, sufficient resources for establishing and maintaining fully equipped biosafety level 3 (BSL-3) laboratories according to international standards are generally available. BSL-3 laboratories are designed to provide several layers of containment to protect the laboratory worker as well as the outside environment and community from risk of exposure in case of local contamination. However, such facilities are scarce in high-burden settings, primarily due to the high financial burden and complexity of the initial construction and/or regular maintenance. Measures to prevent unintended exposure to Mycobacterium tuberculosis during laboratory manipulation of specimens and cultures is the first, and by far the most important, aspect of containment. This paper focuses on the need for risk containment at source. Assuming that in many settings the establishment of BSL-3 laboratories with all the required features is not achievable, this paper also discusses the minimum requirements necessary to mitigate risks associated with particular laboratory procedures. The term 'TB containment laboratory' is used throughout this paper to describe the minimum requirements for a laboratory suitable for high-risk procedures. The TB containment laboratory has many, but not all, of the features of a BSL-3 laboratory.
在工业化国家，通常有足够的资源按照国际标准建立和维护设备齐全的三级生物安全实验室（BSL-3）。BSL-3实验室旨在提供多层防护，以保护实验室工作人员以及外部环境和社区，防止在局部污染情况下受到暴露风险。然而，在高负担地区，此类设施稀缺，主要原因是初始建设和/或定期维护的经济负担高昂且复杂。在实验室对标本和培养物进行操作期间，预防意外接触结核分枝杆菌的措施是防护的首要且迄今为止最重要的方面。本文着重于源头风险控制的必要性。假设在许多情况下，建立具备所有所需特征的BSL-3实验室无法实现，本文还讨论了降低与特定实验室程序相关风险所需的最低要求。本文通篇使用“结核病防护实验室”这一术语来描述适合高风险程序的实验室的最低要求。结核病防护实验室具备BSL-3实验室的许多但并非全部特征。
