我国实验室获得性感染的回顾性分析

Retrospective analysis of laboratory-acquired infection in China

目的 收集文献报道的我国实验室获得性感染(laboratory-acquired infections, LAI)的病例,总结国内LAI感染途径和引起感染的原因,旨在提高实验室人员对其职业健康和安全风险的认识。方法 在线搜集截至2022年4月11日PubMed、中国知网、万方数据库、CBM中国生物医学文献数据库等数据库有关中国LAI报告的病例资料,回顾分析LAI报道的数量和原因,LAI的主要危险因素及对社会的危害,发生LAI或病原微生物泄漏的后果,以及提出生物安全的相关对策。结果 当前收集到LAI报告22份,经过阅读整合为21份,病原微生物7种,主要的致病微生物室是汉坦病毒(42.86%, n=9)和布鲁氏菌(33.33%, n=7),实验室发病人数122人,死亡3人。大部分报道来自于研究型实验室(66.67%, n=14),感染途径以摄入气溶胶为主(42.86%, n=9),其次为经皮肤途径(38.09%, n=8)。结论 不报告LAI事件会增加病原微生物通过受感染实验室工作人员传播到实验室以外人员和环境的风险。应鼓励地方卫生机构和实验室报告LAI病例,作为监测病原微生物意外泄漏和进一步改善实验室生物安全的有力工具。实验室需要强有力的生物安全措施来保护工作人员的健康并防止病原微生物意外泄露造成的环境污染。

Objective To collect the cases of laboratory-acquired infections(LAI) reported in literatures in China,summarize the infection routes and causes of LAI in China, in order to improve laboratory staff’s understanding of itsoccupational health and safety risks.Methods The cases of laboratory-acquired infection reported in domestic literatureswere collected from Pub Med, CNKI, Wanfang Database, CBM China Biomedical Literature Database up to April 11, 2022,retrospectively analyze the number and causes of LAI reports, the main risk factors of LAI and its harm to society, theconsequences of LAI or the leakage of pathogenic microorganisms, and put forward the relevant countermeasures of biologicalsafety.Results A total of 22 LAI reports were collected, reviewed and integrated into 21 reports. There were 7 kinds ofpathogenic microorganisms. The main pathogenic microorganisms were hantavirus(42.86%, n=9) and Brucella(33.33%, n=7).There were 122 cases and 3 deaths in the laboratory. Most of the reports came from research laboratories(66.67%, n=14). Themain route of infection was inhalation of aerosol(42.86%, n=9), followed by transdermal route(38.09%, n=8).Conclusions Failure to report LAI events will increase the risk of pathogenic microorganisms spreading to people outsidethe laboratory and the environment through infected laboratory staff. Local health institutions and laboratories should beencouraged to report LAI cases as a powerful tool for monitoring accidental leakage of pathogenic microorganisms and furtherimproving laboratory biosafety. The laboratory needs strong biosafety measures to protect staff’s health and preventenvironmental pollution caused by accidental leakage of pathogenic microorganisms.