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Cited by 63Chemical Safety and Risk ManagementInfection Control in HealthcareBacillus and Francisella bacterial research

Laboratory-acquired infections and pathogen escapes worldwide between 2000 and 2021: a scoping review

Open access
Blacksell, Stuart D, Dhawan, Sandhya, Kusumoto, Marina, Le, Khanh K, Summermatter, Kathrin, O’Keefe, Joseph, Kozlovac, Joseph P, Almuhairi, Salama S +8 more·2024·The Lancet Microbe
DOI 10.1016/s2666-5247(23)00319-1
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Abstract

Laboratory-acquired infections (LAIs) and accidental pathogen escape from laboratory settings (APELS) are major concerns for the community. A risk-based approach for pathogen research management within a standard biosafety management framework is recommended but is challenging due to reasons such as inconsistency in risk tolerance and perception. Here, we performed a scoping review using publicly available, peer-reviewed journal and media reports of LAIs and instances of APELS between 2000 and 2021. We identified LAIs in 309 individuals in 94 reports for 51 pathogens. Eight fatalities (2·6% of all LAIs) were caused by infection with Neisseria meningitidis (n=3, 37·5%), Yersinia pestis (n=2, 25%), Salmonella enterica serotype Typhimurium (S Typhimurium; n=1, 12·5%), or Ebola virus (n=1, 12·5%) or were due to bovine spongiform encephalopathy (n=1, 12·5%). The top five LAI pathogens were S Typhimurium (n=154, 49·8%), Salmonella enteritidis (n=21, 6·8%), vaccinia virus (n=13, 4·2%), Brucella spp (n=12, 3·9%), and Brucella melitensis (n=11, 3·6%). 16 APELS were reported, including those for Bacillus anthracis, SARS-CoV, and poliovirus (n=3 each, 18·8%); Brucella spp and foot and mouth disease virus (n=2 each, 12·5%); and variola virus, Burkholderia pseudomallei, and influenza virus H5N1 (n=1 each, 6·3%). Continual improvement in LAI and APELS management via their root cause analysis and thorough investigation of such incidents is essential to prevent future occurrences. The results are biased due to the reliance on publicly available information, which emphasises the need for formalised global LAIs and APELS reporting to better understand the frequency of and circumstances surrounding these incidents.

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Research works printed but not linked: 2

  1. Kisskalt K. Laboratory infections with typhoid bacilli. Z Hyg Infektionskrahkh 1915; 80: 145-62.
  2. World Organisation for Animal Health. Chapter 1.1.4. Biosafety and biosecurity: standard for managing biological risk in the veterinary laboratory and animal facilities. In: Manual of diagnostic tests and vaccines for terrestrial animals, 2021. https://www.woah.org/ fileadmin/Home/eng/Health_standards/tahm/1.01.04_ BIOSAFETY_BIOSECURITY.pdf (accessed Oct 26, 2023).

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Authors
Blacksell, S. D., Dhawan, S., Kusumoto, M., Le, K. K., Summermatter, K., O’Keefe, J., Kozlovac, J. P., Almuhairi, S. S., Sendow, I., Scheel, C. M., Ahumibe, A., Masuku, Z. M., Bennett, A. M., Kojima, K., Harper, D. R., & Hamilton, K.
Affiliations
  • Mahidol University (TH)
  • University of Bern (CH)
  • Ministry for Primary Industries (NZ)
  • Agricultural Research Service (US)
  • National Research and Innovation Agency (ID)
  • Centers for Disease Control and Prevention (US)
  • Nigeria Centre for Disease Control (NG)
  • National Health Laboratory Service (ZA)
  • UK Health Security Agency (GB)
  • World Health Organization (CH)
  • Chatham House (GB)
  • Organisation Mondiale de la Santé Animale (FR)
Corresponding author
Blacksell, Stuart D
ORCID
Venue
The Lancet Microbe
Publisher
Elsevier BV
Published
2024-02
Volume
5
Issue
2
Pages
e194-e202
ISSN
2666-5247 (ISSN-L)
DOI
10.1016/s2666-5247(23)00319-1
OpenAlex
W4389606405
Cited by
63
References
29
Citations by year
2026: 19 · 2025: 28 · 2024: 16
FWCI
3.38
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Microbe (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • BORIS (University Library Bern) (submittedVersion, cc-by)
Funders
  • Centers for Disease Control and Prevention
  • Wellcome Trust (220211)
  • Global Affairs Canada
Topics
  • Physical Sciences › Chemical Engineering › Chemical Health and Safety › Chemical Safety and Risk Management
  • Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bacillus and Francisella bacterial research
Keywords
laboratory-acquired infection, biosafety, laboratory risk management, Salmonella typhimurium, Salmonella Enteritidis, Brucella, vaccinia virus, Neisseria meningitidis, Yersinia pestis, Ebola virus, SARS-CoV, poliovirus, foot-and-mouth disease virus, variola virus, root cause analysis, incident reporting
MeSH terms
Animals, Cattle, Humans, Laboratory Infection, Salmonella enteritidis, Salmonella typhimurium, Yersinia pestis, Influenza A Virus, H5N1 Subtype

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