Laboratory acquired infections: myth or reality

Introduction. Laboratory-acquired infections (LAIs) are a concerning aspect of scientific research and laboratory work. These infections occur when laboratory personnel or researchers are inadvertently exposed to infectious agents while handling biological materials in a laboratory setting. LAIs can involve bacteria, viruses, fungi, or other pathogenic microorganisms. Although most LAIs have no consequence for the worker, the potential consequences of LAIs can range from mild illness to severe, life-threatening conditions, depending on the infectious agent involved and the level of exposure. Some common routes of transmission include inhalation, accidental needle sticks, splashes, or direct contact with contaminated surfaces. To mitigate the risk of LAIs, laboratories must adhere to strict biosafety and biosecurity protocols. These protocols include the use of personal protective equipment (PPE), proper handling and containment of infectious materials, regular risk assessments, and ongoing training for laboratory personnel. Of all LAIs there are no distinguishable accidents or exposure events identified in more than 80% of the reported cases. Additionally, researchers must maintain a culture of safety consciousness. Furthermore, continuous improvement in laboratory practices, advancements in containment technology and collaboration among scientists, safety experts, and health authorities are crucial to minimizing the occurrence of laboratory-acquired infections and safeguarding the well-being of laboratory workers. Aim. The aim of this presentation is to present two case studies of LAIs at Leiden University Medical Center that were investigated to determine the cause of the LAIs.Material and methods.The LAIs were investigated by the biological safety officer through interviews and site visits to the laboratories where the causes of the LAIs were supposed to be identified. Results.The first LAI investigated occurred at the clinical microbiology department. During the diagnostic testing of patient samples, no obvious cause for the patient's disease was found based on routine bacterial cultures. An outdated method of characterizing bacteria, involving the opening of plates and sniffing the odor, was used, although this approach was already prohibited in the biosafety protocols. This method yielded no clues. However, slow-growing bacterial colonies were observed during culturing. Subsequent culturing identified the colonies as Brucellaspp. In another case, an LAI was caused by Plasmodium falciparum, the parasite responsible for malaria. This LAI was discovered following a mosqui-to bite on one of the researchers. Despite efforts to count mosquitoes before and after the experiment to prevent their escape from the isolator, it seems there was a mosquito escape. The researcher's blood was drawn, and the parasites in the blood were cultured. The results of this culturing and identification of the parasites revealed an unnoticed LAI that occurred during malaria research. Conclusions. Although the level of biosafety and biosecurity at the Leiden University Medical Center is considered to be high, LAIs still occur. The causes of these LAIs are either workers not adhering to biosafety protocols or failures in the containment equipment

Attachment of origins of replication to the nuclear matrix and the chromosomal scaffold

AbstractWe have investigated the attachment of DNA to the nuclear matrix and chromosomal scaffold in synchronized bovine liver cells. Label incorporated at the onset of the S phase remained preferentially associated with the matrix during the subsequent G1 phase and with a residual protein structure from dehistonized chromosomes during mitosis. On the other hand label incorporated during mid or late S phase was about equally distributed over the DNA molecule after a chase into the G1 phase. These results suggest that DNA is attached to the nuclear matrix and chromosome scaffolds by the origins of replication

Managing Biological Risks in Biomedical laboratories of Public Hospitals in Athens, Greece, based on the Biosafety requirements

Objectives: The aim of the present study was to review the laboratory workers’ perception on the biological risks in Biomedical laboratories of Public Hospitals in Athens, Greece, to evaluate how they are managing the biological materials and to propose mitigation measures according to the existing risk, the local legislations and the international Biosafety guidelines. Materials and Methods: The study was designed as a cross-sectional study with a detailed health and safety (H&S) questionnaire focused on biosafety and biorisk management. A total of 36 biomedical laboratories Biosafety Level-2 in 20 public hospitals were assessed for their biosafety containment and compliance with biosafety practices. Laboratory staff (medical laboratory doctors, medical laboratory technologists, laboratory assistants, biologists and biochemists) (n = 415) completed the questionnaire. Results: The results showed, that a significant percentage of laboratories lacked proper management of the biological agents and biological materials in general, thus more specific: restricted access 48.9%, controlled and independent ventilation 36.6%, use of BSCs 31.8%, biorisk management system in place 31.6%, risk assessments 28.4%, biosafety manuals 21.4%, SOPs 35.9%, assigned biosafety officers 10.8%, occupational Doctor 34.9%, accidents reporting 25.5%, emergencies plan 34.2% and biosafety training programs 28.2%. Conclusion: There are marked deficiencies in containment and administrative controls, as well as in the implementation of the Greek and EU biosafety legislation. This emphasize the urgency of addressing critical gaps in biosafety and in emergency preparedness in Greek biomedical laboratories. Therefore a Biorisk Management System, risk assessments, SOPs, assignment of a Biosafety Officer, staff trainings and emergency response plans should be developed, applied and enforced, in compliance with the local and European legislation and guidelines

Combining biosafety expert’s evaluation and workers’ perception regarding the Biological Risks in Biomedical laboratories of Public Hospitals in Athens, Greece

Objectives: The aim of the present study was by combining an expert’s evaluation and laboratory workers’ perception, to review the biological risks in biomedical laboratories of public hospitals in Athens, Greece. It was also to evaluate how they are managing the biological materials, the level of safety awareness and training of the personnel, and to propose mitigation measures according to the existing risks, based on the local legislation and the international Biosafety guidelines. Materials and Methods: A total of 36 biosafety level-2 (BSL2) biomedical laboratories in 20 public hospitals were assessed for their biosafety containment specifics and compliance with biosafety practices. The study was designed as a cross-sectional study, with a checklist and a detailed health and safety (H&S) questionnaire, focused on biosafety and biorisk management. An expert biosafety officer observed and filled in a checklist for each biomedical laboratory (n=36) of the 20 hospitals. Laboratory staff (medical laboratory doctors, medical laboratory technologists, laboratory assistants, biologists and biochemists; n = 415) filled in a specific to biosafety H&S question­naire in each of these laboratories. Results: Both the results from the checklists and the questionnaires showed that in a significant percentage of laboratories there are the following deficiencies: restricted access and signage at the entrance, autoclaves in the laboratory area, ability to use the washbasins hands-free, biorisk management system, written risk assessments, biosafety manuals, standard operating procedures (SOPs), assigned biosafety officers, protocols  about the use of Personal Protective Equipment (PPE), insufficient biosafety training programs, accidents reporting, eyewash emergency shower system, first aid kits and emergency telephone numbers. On the positive site laboratory procedures are separated from management, sanitary and rest areas, laboratory surfaces and floors are easy to clean and disinfect, good laboratory Practices followed for all procedures, waste management is in compliance with the current Greek legislation and there are sufficient PPE available. Conclusion: In the laboratories studied there are significant shortcomings in containment and administrative controls, in the application of Greek and EU biosafety legislation, and in the proper management of biological agents and materials in general. This emphasizes the importance of closing key gaps in biosafety and emergency preparedness, in the biomedical laboratories. Using the results of this study, actions should be developed, applied and enforced, in compliance with the local and European legislation and guidelines. This could enhance the safety of these facilities, and the laboratory professionals, the community and the environment could be better protected from possible harmful biological agents and the possibility of Laboratory acquired infections (LAIs). This study also demonstrated the value of the laboratory workers participation in the risk evaluation, despite their propensity to over or under-estimate the risk level of the possible hazards. That fact should be considered in future studies when enhancing hospital staff

Managing Biological Risks in Biomedical laboratories of Public Hospitals in Athens, Greece, based on the Biosafety requirements

Objectives: The aim of the present study was to review the laboratory workers’ perception on the biological risks in Biomedical laboratories of Public Hospitals in Athens, Greece, to evaluate how they are managing the biological materials and to propose mitigation measures according to the existing risk, the local legislations and the international Biosafety guidelines. Materials and Methods: The study was designed as a cross-sectional study with a detailed health and safety (H&S) questionnaire focused on biosafety and biorisk management. A total of 36 biomedical laboratories Biosafety Level-2 in 20 public hospitals were assessed for their biosafety containment and compliance with biosafety practices. Laboratory staff (medical laboratory doctors, medical laboratory technologists, laboratory assistants, biologists and biochemists) (n = 415) completed the questionnaire. Results: The results showed, that a significant percentage of laboratories lacked proper management of the biological agents and biological materials in general, thus more specific: restricted access 48.9%, controlled and independent ventilation 36.6%, use of BSCs 31.8%, biorisk management system in place 31.6%, risk assessments 28.4%, biosafety manuals 21.4%, SOPs 35.9%, assigned biosafety officers 10.8%, occupational Doctor 34.9%, accidents reporting 25.5%, emergencies plan 34.2% and biosafety training programs 28.2%. Conclusion: There are marked deficiencies in containment and administrative controls, as well as in the implementation of the Greek and EU biosafety legislation. This emphasize the urgency of addressing critical gaps in biosafety and in emergency preparedness in Greek biomedical laboratories. Therefore a Biorisk Management System, risk assessments, SOPs, assignment of a Biosafety Officer, staff trainings and emergency response plans should be developed, applied and enforced, in compliance with the local and European legislation and guidelines

A swift risk analysis for COVID-19 testing facilities using rapid tests

Introduction. COVID-19 is an infectious disease of International Concern, due to the wide-spread geographic impact and high transmissibility, causing severe illnesses. Many testing facilities were set-up for monitoring the spread of the SARS-CoV-2 virus, at the early days of the coronavirus pandemic. From Biosafety aspect this study investigates a reliable risk assessment method to identify and mitigate the risks of COVID-19 testing facilities using Rapid diagnostic tests (POCT), in order to protect the staff, the people who got tested, the community and the environment. Material and methods. Many techniques have been used so far for performing a risk assessment. In the present study, SWIFT analysis suitable for biosafety facilities and for risks of different magnitude, was used for identifying threats and hazards and to calculate the risks for COVID-19 testing facilities. Results. Our analysis showed several initial and potential risks, which could lead to unwanted exposure or release of the SARS-CoV-2, and/or unwanted infection of staff and patients. With minor adjustments of the testing facility, by creating standard operating procedures and awareness of the potential risks, most of the identified risks could be mitigated. Conclusions. Our study demonstrated that when setting up a COVID-19 testing facility, a proper risk assessment should be part of the process, in order to ensure the safety of staff, patients, and the environment. Additionally, we proposed a number of multiple mitigation measures and recommendations, with the goal to reduce the risks during the rapid testing diagnostic procedure.Introducere. COVID-19 este o boală infecțioasă cu un impact geografic larg răspândit și transmisibilitate ridicată, care poate provoacăboli grave. Încă de la debutul pandemiei de COVID-19 au fost înființate multe stații de testare pentru monitorizarea răspândirii virusu-lui SARS-CoV-2. Din punct de vedere al biosecurității acest studiu investighează o metodă de evaluare a riscurilor în vederea identificării și atenuării riscurilor stațiilor de testare COVID-19, care utilizează teste de diagnosticare rapidă (POCT) pentru a proteja personalul, pacienții, comunitatea și mediul. Material și metode. În prezentul studiu au fost aplicate diferite tehnici pentru realizarea unei evaluări a riscurilor. A fost utilizată analiza SWIFT pentru instalațiile de biosecuritate și pentru riscuri de diferită amploare pentru identificarea amenințărilor și pericolelor, și pentru a calcula riscurile pentru stațiile de testare COVID-19. Rezultate. Analiza noastră a identificat mai multe riscuri inițiale și potențiale, care ar putea duce la expunerea sau eliberarea nedorită a SARS-CoV-2 și/sau la infectarea nedorită a personalului și a pacienților. Cu ajustări minore ale stațiilor de testare, prin crearea de proceduri standard de operare și conștientizarea riscurilor potențiale, majoritatea riscurilor identificate ar putea fi atenuate. Concluzii. Prezentul studiu a demonstrat că atunci când se înființează o unitate de testare COVID-19, o evaluare adecvată a riscurilor ar trebui să facă parte din proces pentru a asigura siguranța personalului, a pacienților și a mediului. În plus, am propus o serie de măsuri și recomandări multiple de atenuare cu scopul de a reduce riscurile în timpul procedurii de diagnosticare a testării rapide

Inhibition of β2 Integrin–mediated Leukocyte Cell Adhesion

Many integrins mediate cell attachment to the extracellular matrix by recognizing short tripeptide sequences such as arginine–glycine–aspartic acid and leucine–aspartate–valine. Using phage display, we have now found that the leukocyte-specific b2 integrins bind sequences containing a leucine–leucine–glycine (LLG) tripeptide motif. An LLG motif is present on intercellular adhesion molecule (ICAM)-1, the major b2 integrin ligand, but also on several matrix proteins, including von Willebrand factor. We developed a novel b2 integrin antagonist peptide CPCFLLGCC (called LLG-C4), the structure of which was determined by nuclear magnetic resonance. The LLG-C4 peptide inhibited leukocyte adhesion to ICAM-1, and, interestingly, also to von Willebrand factor. When immobilized on plastic, the LLG-C4 sequence supported the b2 integrin–mediated leukocyte adhesion, but not b1 or b3 integrin–mediated cell adhesion. These results suggest that LLG sequences exposed on ICAM-1 and on von Willebrand factor at sites of vascular injury play a role in the binding of leukocytes, and LLG-C4 and peptidomimetics derived from it could provide a therapeutic approach to inflammatory reactions

Risk assessment for the implementation of controlled human Schistosoma mansoni infection trials in Uganda.

Schistosomiasis is a parasitic infection highly prevalent in sub-Saharan Africa, and a significant cause of morbidity; it is a priority for vaccine development. A controlled human infection model for Schistosoma mansoni (CHI-S) with potential to accelerate vaccine development has been developed among naïve volunteers in the Netherlands. Because responses both to infections and candidate vaccines are likely to differ between endemic and non-endemic settings, we propose to establish a CHI-S in Uganda where Schistosoma mansoni is endemic. As part of a "road-map" to this goal, we have undertaken a risk assessment. We identified risks related to importing of laboratory vector snails and schistosome strains from the Netherlands to Uganda; exposure to natural infection in endemic settings concurrently with CHI-S studies, and unfamiliarity of the community with the nature, risks and rationale for CHI. Mitigating strategies are proposed. With careful implementation of the latter, we believe that CHI-S can be implemented safely in Uganda. Our reflections are presented here to promote feedback and discussion