Journal article
Clinical Laboratory Biosafety Gaps: Lessons Learned from Past Outbreaks Reveal a Path to a Safer Future
Clinical microbiology reviews, Vol.34(3), pp.e0012618-e0012618
06/16/2021
DOI: 10.1128/CMR.00126-18
PMCID: PMC8262806
PMID: 34105993
Abstract
Patient care and public health require timely, reliable laboratory testing. However, clinical laboratory professionals rarely know whether patient specimens contain infectious agents, making ensuring biosafety while performing testing procedures challenging.
SUMMARY Patient care and public health require timely, reliable laboratory testing. However, clinical laboratory professionals rarely know whether patient specimens contain infectious agents, making ensuring biosafety while performing testing procedures challenging. The importance of biosafety in clinical laboratories was highlighted during the 2014 Ebola outbreak, where concerns about biosafety resulted in delayed diagnoses and contributed to patient deaths. This review is a collaboration between subject matter experts from large and small laboratories and the federal government to evaluate the capability of clinical laboratories to manage biosafety risks and safely test patient specimens. We discuss the complexity of clinical laboratories, including anatomic pathology, and describe how applying current biosafety guidance may be difficult as these guidelines, largely based on practices in research laboratories, do not always correspond to the unique clinical laboratory environments and their specialized equipment and processes. We retrospectively describe the biosafety gaps and opportunities for improvement in the areas of risk assessment and management; automated and manual laboratory disciplines; specimen collection, processing, and storage; test utilization; equipment and instrumentation safety; disinfection practices; personal protective equipment; waste management; laboratory personnel training and competency assessment; accreditation processes; and ethical guidance. Also addressed are the unique biosafety challenges successfully handled by a Texas community hospital clinical laboratory that performed testing for patients with Ebola without a formal biocontainment unit. The gaps in knowledge and practices identified in previous and ongoing outbreaks demonstrate the need for collaborative, comprehensive solutions to improve clinical laboratory biosafety and to better combat future emerging infectious disease outbreaks.
Details
- Title: Subtitle
- Clinical Laboratory Biosafety Gaps: Lessons Learned from Past Outbreaks Reveal a Path to a Safer Future
- Creators
- Nancy E Cornish - Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USANancy L Anderson - Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USADiego G Arambula - Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USAMatthew J Arduino - Centers for Disease Control and Prevention, National Center for Emerging & Zoonotic Infectious Diseases (NCEZID), Atlanta, Georgia, USAAndrew Bryan - Department of Laboratory Medicine, University of Washington, Seattle, Washington, USANancy C Burton - Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio, USABin Chen - Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USABeverly A Dickson - Department of Clinical Pathology, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USAJudith G Giri - Centers for Disease Control and Prevention, Center for Global Health (CGH), Atlanta, Georgia, USANatasha K Griffith - High Containment Core, Georgia State University, Atlanta, Georgia, USAMichael A Pentella - College of Public Health, The University of Iowa, Iowa City, Iowa, USAReynolds M Salerno - Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USAParamjit Sandhu - Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USAJames W Snyder - Department of Pathology and Laboratory Medicine, University of Louisville, Louisville, Kentucky, USAChristopher A Tormey - Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut, USA, Pathology & Laboratory Medicine Service, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USAElizabeth A Wagar - Department of Laboratory Medicine, University of Texas, M.D. Anderson Cancer Center, Houston, Texas, USAElizabeth G Weirich - Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USASheldon Campbell - Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut, USA, Pathology & Laboratory Medicine Service, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA
- Resource Type
- Journal article
- Publication Details
- Clinical microbiology reviews, Vol.34(3), pp.e0012618-e0012618
- DOI
- 10.1128/CMR.00126-18
- PMID
- 34105993
- PMCID
- PMC8262806
- NLM abbreviation
- Clin Microbiol Rev
- ISSN
- 0893-8512
- eISSN
- 1098-6618
- Language
- English
- Date published
- 06/16/2021
- Academic Unit
- Central Control Hygienic Laboratory; Epidemiology
- Record Identifier
- 9984214842502771
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