LABORATORY ACQUIRED INFECTIONS

• ASHISH KUMAR SINGH

• ROLL NO. 11
CONTENTS

• Introduction
• Definition
• History
• Top ten common LAI
• Potential route of transmission
• Notifying a LAI
• Risk management
• Management of lab accidents
• LAI- lessons learned
INTRODUCTION
• Laboratory-acquired infections (LAIs), also called
occupational illness or laboratory-associated infections, are
not new phenomena in microbiological laboratories. LAIs
can arise in clinical laboratories as well as in animal
facilities, R&D or production installations. It is sometimes
difficult to determine if a worker's infectious disease is
caused by a micro-organism that is present in the laboratory
only or also in the community. LAIs are of public health
concern, as an infected worker may present a risk of
transmission to his colleagues, relatives, family members or
other citizens.
Definition of LAI
• Laboratory acquired infection (LAI) = an infection obtained
through laboratory or laboratory-related activities as a
result of work with infectious biological agents, which may
be either symptomatic of asymptomatic
 History of LAIs
• Four hallmark studies by Pike and Sulkin collectively identified 4,079
LAIs resulting in 168 deaths between 1930 – 1978

• 159 causative agents identified, although >50% were caused by 10 most

common organisms

• Many more LAIs likely unreported during this time period

(1930-1978)

Source: Pike, 1976 & 1978

 Potential Routes of Transmission

• Inhalation – infectious aerosols, droplets

• Ingestion – mouth pipetting; eating, drinking

• Percutaneous inoculation – needlesticks and other contaminated

sharps; animal bites; exposure to previously broken or damaged skin

• Mucous membrane exposure – infectious materials in contact with

eyes, nose, mouth (splashes, contact from contaminated surfaces)
Notifying a bio-incident or a laboratory-
acquired infection

• Following a bio-incident there is a legal provision requiring to notify:

• Any accident or incident (in relation to a workplace) which may have
resulted in the release of a biological agent (pathogenic and/or
genetically modified organism) and which can cause serious illness
or infection in humans;
• Any incident (in relation to a "contained use" workplace) during the
contained use where a significant amount of pathogenic and/or
genetically modified organisms is unintentionally released in the
environment with immediate or long term risk to human and animal
health and the environment.
 Hieranchy Of Risk Management
Assigning the Biosafety Level

Elimination or Substitution

Engineering Controls

Administrative Controls

Practices and Procedures

Personal Protective Equipment

 Risk Management

• The basic approach

– Practice universal precautions

• Develop and implement a Safety Plan

– to handle accidental spills of infectious material
– or releases of infectious microorganisms
– for Sharps handling
– plan for waste management and disposal
 Management of Lab accidents

• Adequate job specific training

• Proper immunization of laboratory employees
• Facility design and work flow that limits
possible exposure
• Proper use of personal protective equipment
• Establishment of SOPs (standard procedures)
• Understanding our Limitations/cautions of
using automated instrumentation for special
pathogen identification
 Management of Lab accidents

• Laboratory management is responsible ultimately to

implement the procedures and work practices

• Emphasize on risk assessment, training,

SOPs, disinfection, waste management,
immunization, post-exposure prophylaxis, &
biosecurity
 LAIs – Lessons Learned
• Prevention of LAIs can be achieved through:
– Risk assessment! Risk assessment! Risk assessment!
– Establishment of SOPs (controls) appropriate for infectious organisms
used
– Immunization, when available
– Education and training
– Use of appropriate precautions including engineering, administrative, and
PPE controls
– Understanding of disease signs & symptoms
– Prompt injury/accident/illness reporting
 A Simple Reminder…
…on the wall in every laboratory
THANK YOU!