Preventing Laboratory-Acquired Brucellosis in the Era of MALDI-TOF Technology and Molecular Tests: A Narrative Review
Abstract
:Simple Summary
Abstract
1. Introduction
2. Brucella: A Highly Transmissible Organism
3. Human Brucellosis, a “Great Imitator”
4. Diagnosing Human Brucellosis
5. Brucella Cultures and Laboratory Safety
6. Brucellar Identification by Traditional Methods
7. Identification by MALDI-TOF Technology
8. Identification by Molecular Methods
9. Post-Exposure Prophylaxis and Other Measures
10. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Category | Hazard | |
---|---|---|
Bacteriological features of brucellae | Low infecting dose | |
Multiple portals of entry to the human body | ||
High infectivity | ||
Long-term persistence on inanimate surfaces | ||
Exponential biomass growth during incubation | ||
Epidemiology | High burden of disease in endemic areas | |
Clinical disease | Unspecific symptoms and signs | |
Mimics other infectious and non-infectious conditions | ||
Lack of communication with the laboratory | ||
Contamination of a wide diversity of clinical specimens | ||
Identification of the isolate | Unfamiliarity with the genus in non-endemic regions | |
Inconspicuous appearance of colonies | ||
Misleading Gram stain | ||
Misidentification by | commercial biochemical kits | |
MALDI-TOF technology | ||
molecular methods | ||
Unsafe laboratory practices | Lack of biosafety protocols | |
Lack of personal protective equipment | ||
Work in an open bench | ||
Eating, drinking, or smoking at the workstation | ||
Aerosolization of living bacteria by centrifugation, vortexing, catalase test, inadequate sterilization of exhaust gas, and malfunction of biological safety cabinets | ||
Accidents such as spillage of media, breakage of tubes, and needle stick injuries | ||
Environment and laboratory equipment | Crowding | |
Poorly designed ventilation systems | ||
Malfunction or improper use of biological safety cabinets |
Risk Category | Exposure Setting | Post Exposure Measures | ||||||
---|---|---|---|---|---|---|---|---|
Enriched Material a and Reproductive Clinical Specimens | Other Clinical Specimens | |||||||
Work outside of a CCBSC b | Work at <5 Feet from Someone Working outside a CCBSC b | Work on a CCBSC b without PPE c | Aerosol-Generating Procedures on an Open Bench | Contact with Mucosae or Broken Skin | Post-Exposure Prophylaxis | Serological Follow-Up | Clinical Monitoring | |
High | Yes | Yes | Yes | Yes | Yes | Yes | 6 months | 6 months |
Low | No | No | No | No | No | No | 6 months | 6 months |
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Yagupsky, P. Preventing Laboratory-Acquired Brucellosis in the Era of MALDI-TOF Technology and Molecular Tests: A Narrative Review. Zoonotic Dis. 2022, 2, 172-182. https://doi.org/10.3390/zoonoticdis2040016
Yagupsky P. Preventing Laboratory-Acquired Brucellosis in the Era of MALDI-TOF Technology and Molecular Tests: A Narrative Review. Zoonotic Diseases. 2022; 2(4):172-182. https://doi.org/10.3390/zoonoticdis2040016
Chicago/Turabian StyleYagupsky, Pablo. 2022. "Preventing Laboratory-Acquired Brucellosis in the Era of MALDI-TOF Technology and Molecular Tests: A Narrative Review" Zoonotic Diseases 2, no. 4: 172-182. https://doi.org/10.3390/zoonoticdis2040016