What is the difference between Risk Group & Containment Level?
Risk Group: The relative hazard posed by an infectious agent in the lab.
Containment Level: The precautions needed perform a particular technique with a particular agent in order to protect lab workers/public/environment.
What are the requirements for a Containment Level 1 lab?
Lab Design:
- An open benchtop
- Sink
Equipment:
- “Standard PPE:”
- Gloves
- Lab coat
- Eye protection
Practices:
- “Standard microbiological practices:”
- Avoid splashes + aerosols.
- Safe sharps handling.
- Mechanical pipetting.
- Decontaminate work surfaces.
What are the requirements for a Containment Level 2 lab?
Lab Design:
- Biohaz signs
- Autoclave
Equipment:
- BSC I or II
Practices:
- Limited access
- Extra sharps precautions
- Respiratory protection, as required
- Biosafety manual with policies on decontam + medical surveillance
What are the requirements for a Containment Level 3 lab?
Lab Design:
- Physically separated from the main access corridors.
- Double doors, self-closing.
- NEGATIVE pressure airflow into the lab.
- Do not recycle lab exhaust air.
Equipment:
- Respiratory protection as needed.
Practices:
- Controlled access.
- Decontaminate waste + clothes.
- Store serum specimens of lab personnel.
What are the requirements for a Containment Level 4 lab?
Lab Design:
- In a separate building, or an isolated zone.
- Dedicated air supply+exhaust vacuum, and a decontamination system.
- UV light rooms, + autonomous systems to detect + destroy pathogens.
Equipment:
- BSC III,orNSC I/II plusfull-body positive-pressure personnel suit with its own air supply.
Practices:
- Change clothes before entering.
- Shower + decontaminate all material on exit.
Name 5 Risk Group 3 organisms
- Bacillus anthracis
- Brucella
- Burkholderia (pseudo)mallei
- Botulinum toxin
- Chlamydia psittaci (avian strains)
- Francisella tularensis (type A)
- MTB/M. bovis (non-BCG)
- Pasteurella multocida
What Risk Group is Bacillus anthracis?
RG3
What Risk Group is Brucella?
RG3
What Risk Group is Burkholderia mallei/B.pseudomallei?
RG3
What Risk Group is Clostridium botulinum?
RG3
What Risk Group is Chlamydophila psittaci?
RG3, for avian strains.
What Risk Group is Francisella tularensis?
RG3
(type A) {}
What Risk Group is Mycobacterium tuberculosis?
RG3
What Risk Group is Mycobacterium bovis?
RG3
(non-BCG)
What Risk Group is Pasteurella multocida?
RG3
What Risk Group is Yersinia pestis?
RG3
What Risk Group are Blastomyces spp?
RG3
What Risk Group are Histoplasma spp?
RG3
What Risk Group are Coccidioides spp?
RG3
What organisms is Brucella frequently mis-identified as by automated ID?
- Psychrobacter phenylpyruvicus (prev. Moraxella ~).
- Oligella ureolytica
- Ochrobactrum anthropi
Lab precautions for working with dimorphic fungi
In 2009, Coccidioides was reported as the #10 most frequently reported LAI (Singh 2009 CID 49:142).
They are RG3 pathogens, so need Level 3 precautions, e.g.:Work in BSC-ve airflow into labExhaust air not recirculated
Specific for dimorphic fungi:Mould isolates are handled within a BSC to prevent spread of conidia to the lab envt + to protect lab personnelGrow on slants rather than on petri plates
Do not do slide cx’s (wet mounts will show the identifying characteristics)
Careful with MALDI, this is a potential biosafety issue. (And must be sure the organisms are in the db you’re using)
For Coccidioides in particular:
Cocci grown in lab cx (and arthroconidia) are highly infectious, therefore also:Submerge tubed growth under sterile water before handling
How can we monitor TB transmission to HCWs/lab staff?
Lab workers and HCWs receive annual TSTs to ensure early dx of LTBIs so that treatment can be provided ASAP.
