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(1) Mucous membranes (rubbing the nose or eyes with contaminated hands),
(2) Inhalation of aerosols of microorganisms,
(3) Accidental ingestion (putting pens or fingers into the mouth), or
(4) Needle sticks.
Hepatitis B virus can be transmitted to laboratory workers through needle stick injuries.
The CDC estimates that approximately 12.000 health care workers become accidentally
infected with this blood-borne pathogen annually. Human immunodeficiency virus (HIV) is
another blood-borne pathogen that may be transmitted to laboratory personnel from
contaminated specimens through a needle stick injury or another percutaneous route.
Mycobacterium tuberculosis:
It has long been known to cause tuberculosis in laboratory workers exposed to
aerosols created in processing sputum samples. A laboratory accident involving a spill of
active M. tuberculosis, which could easily aerosolize through the ventilation system, is
every microbiologist’s nightmare.
Brucella:
Brucella spp. and Francisella tularensis are other infectious agents that can be
transmitted through inhalation of an aerosol created during the processing or handling of
specimens (e.g., blood, which may harbour these organisms) or cultures of the organism.
Coccidioides:
Coccidioides immitis, the most infectious of all the fungi, can infect several people in a
room if culture plates on which the organism is growing are not sealed with tape or are
open in the absence of a biosafety hood.
Those who work in the laboratory need to use Standard Precautions to minimize
the risk of laboratory-acquired infections and to promote a safe environment for all
personnel in the laboratory and elsewhere.
If there has been leakage of a specimen due to lose capping or breakage, the
safety officer must decide whether the specimen is to be discarded or whether the
difficulty of obtaining a replacement (e.g. one of CSF) is such that the leaking
container should be taken to a safety cabinet and the specimen transferred to a
fresh container.
(1) Inoculation,
(2) Ingestion, or
(3) Inhalation
Ingestion: Ingestion is a route of infection that takes place through the mouth.
It may take place by:
Mouth pipetting is particularly dangerous, for even if the mouth-piece contains a filter, its
end is liable to be contaminated by the fingers. Laboratory rules must forbid mouth
pipetting; there are adequate pieces of equipment which make it unnecessary.
Eating, drinking, smoking and applying cosmetics in the laboratory must be forbidden.
Hands should be washed on completion of work and also on leaving the laboratory.
Also during centrifugation, vibration can generate aerosol within the container. Careless
loading or unloading, breakage during centrifugation or premature opening after breakage
can lead to gross dissemination.
B- GROUP 2: Organisms that rarely cause human disease or infection. They may
be a hazard to laboratory workers, but unlikely to spread in the community.
Effective prophylaxis or treatment is usually available. Most pathogens fall into
this group.
C- GROUP 3: Organisms that may cause severe human disease and present a
serious hazard to laboratory workers. They may pose a risk of spread in the
community, but there is usually effective prophylaxis or treatment.
D- GROUP 4: Organisms that cause severe human disease and pose a serious
risk to laboratory workers. They may pose a high risk of spread in the
community and there is usually no effective prophylaxis or treatment.
These precautions require that blood and body fluids from every patient be treated as
potentially infectious. The essentials of Standard Precautions and safe laboratory work
practices as follows:
The CDC’s Standard Precautions should be followed for handling blood and body
fluids, including all secretions and excretions (e.g., serum, semen, all sterile body fluids,
saliva from dental procedures, and vaginal secretions) submitted to the microbiology
laboratory. Standard Precautions do not apply to feces, nasal secretions, saliva (except in
dental procedures), sputum, sweat, tears, urine, or vomitus unless they are grossly bloody.
Q9: Write on the types of cabinets and their benefits (one of them in
details), and which one is used in the Microbiology lab?
Three classes of cabinet are defined in the British standard; the class required being
determined by the degree of hazard and protection:
Class I cabinets: These cabinets are open-fronted. The exhaust air from the
cabinet is filtered by a high-efficiency particulate air (HEPA) filter. The Class I
biosafety cabinet will provide personnel and environmental protection. Procedures
such as shaking, mixing or ultrasonic disruption of any material likely to contain
dangerous organisms should be done in a class 1 or class 2 cabinet.
Class II cabinets: These are vertical laminar-flow biological cabinets which are
also open-fronted. Class II cabinet provides a HEPA-filtered, re-circulated mass
airflow within the work space. Some of the air is also exhausted from the cabinet,
and filtered by HEPA filters. Thus, the Class II biosafety cabinet will provide
personnel, environment and product protection. Class 2 cabinets are preferred for
work with uninoculated cell cultures and other materials requiring protection from
air-borne contamination.
Class III cabinet: Class III cabinet is a totally enclosed ventilated cabinet of gas-
tight construction. Operations within the Class III cabinet are conducted through
attached rubber gloves. The air pressure in the cabinet being kept less than that in
the room. The cabinet exhaust air is filtered by two HEPA filters, installed in series,
before discharge outside of the facility.
The use of a Class II cabinet in the microbiological laboratory offers the additional
capability and advantage of protecting materials contained within it from extraneous
airborne contaminants. This capability is provided by the HEPA-filtered, recirculated
mass airflow within the workspace.
Pipettes, swabs, and other glass objects should be placed into rigid cardboard
containers before disposal.
Broken glass is placed in thick boxes lined with plastic biohazard bags; when full,
the box is incinerated or autoclaved.
Sharp objects, including scalpels and needles, are placed in sharps containers,
which are autoclaved or incinerated when full.
For jars, clean and disinfect them carefully, preferably by heat. When the material
of the jar will allow it, do so by autoclaving. Refill with fresh disinfectant diluted
accurately to the correct concentration, i.e. weak (1%) or strong (10%)
hypochlorite as appropriate, or phenolic disinfectant at 1-2% concentration. Use
hypochlorite for viruses and phenolic for other purposes, the higher concentration
(2%) of phenolic where tubercle bacilli may be present. Jars must contain enough
disinfectant to cover all that is to be put in them. Carefully discard the used
pipettes, slides and infective fluids into the disinfectant in such a way as to avoid
splashing.