Morse Stephen, Henkel Richard
IHRC, Inc., Atlanta, GA, USA.
Centers for Disease Control and Prevention, Atlanta, GA, USA.
Appl Biosaf. 2018 Mar 1;23(1):11-18. doi: 10.1177/1535676017746695.
, the causative agent of tularemia, is a HHS Tier 1 select agent. Tularemia is the most commonly reported human and animal infection caused by a bacterial select agent in the United States. Because of the rarity of disease, low clinical suspicion, and the organism's low infectious dose, poses a hazard for unsuspecting laboratorians, particularly those who handle cultures outside a biological safety cabinet or without use of appropriate personal protective equipment (PPE). We examined Form 4s and Form 3s submitted to the Federal Select Agent Program between 2011 and 2015 to assess laboratory methods used in the identification of and categorize reported occupational exposures. Culture, which is used in a confirmatory identification, was the primary method used in clinical laboratories. Reported occupational exposures in clinical, veterinary, and reference laboratories occurred at a rate of 33.8, 14.0, and 0.4/100 isolates, respectively. The number of exposed workers in clinical, reference, veterinary, and research laboratories was 3.2, 2.4, 5.1, and 0.9 workers per reported incident, respectively. Most reported occupational exposures occurred in clinical laboratorians working on the bench at BSL-2 conditions with isolated cultures with no suspicion that the organism was ; the fewest occurred in research laboratories at BSL-3 where occupational exposures were prevented by prior knowledge that the organism was and the PPE that was used in these laboratories.
土拉弗朗西斯菌，土拉菌病的病原体，是美国卫生与公众服务部一级选择生物剂。土拉菌病是美国由细菌选择生物剂引起的最常报告的人类和动物感染。由于该疾病罕见、临床怀疑度低以及该生物体的感染剂量低，这对毫无防备的实验室工作人员构成了危害，尤其是那些在生物安全柜外或未使用适当个人防护装备（PPE）处理培养物的人员。我们检查了2011年至2015年提交给联邦选择生物剂计划的4号表格和3号表格，以评估用于鉴定土拉弗朗西斯菌的实验室方法，并对报告的职业暴露进行分类。用于确证鉴定的培养法是临床实验室使用的主要方法。临床、兽医和参考实验室报告的职业暴露发生率分别为每100株分离物33.8、14.0和0.4例。临床、参考、兽医和研究实验室中每起报告事件的暴露工人数量分别为3.2、2.4、5.1和0.9名工人。大多数报告的职业暴露发生在二级生物安全水平（BSL-2）条件下在实验台上处理分离培养物且未怀疑该生物体是土拉弗朗西斯菌的临床实验室工作人员中；最少发生在三级生物安全水平（BSL-3）的研究实验室，在这些实验室中，由于事先知道该生物体是土拉弗朗西斯菌以及在这些实验室中使用的个人防护装备，职业暴露得以预防。
