Brucella Exposure Risk Events in 10 Clinical Laboratories, New York City, USA, 2015 to 2017.

Autor:	Ackelsberg J; Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, New York, New York, USA jackelsb@health.nyc.gov., Liddicoat A; Public Health Laboratory, New York City Department of Health and Mental Hygiene, New York, New York, USA., Burke T; Public Health Laboratory, New York City Department of Health and Mental Hygiene, New York, New York, USA., Szymczak WA; Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA., Levi MH; Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA., Ostrowsky B; Division of Infectious Diseases, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA., Hamula C; Department of Clinical Pathology and Laboratory Medicine, Mount Sinai Medical Center, New York, New York, USA., Patel G; Division of Infectious Diseases, Mount Sinai Medical Center, New York, New York, USA., Kopetz V; Clinical Laboratory, Richmond University Medical Center, Staten Island, New York, USA., Saverimuttu J; Department of Infectious Disease, Richmond University Medical Center, Staten Island, New York, USA., Sordillo EM; Department of Clinical Pathology and Laboratory Medicine, Mount Sinai Medical Center, New York, New York, USA.; Division of Infectious Diseases, Mount Sinai Medical Center, New York, New York, USA., D'Souza D; Division of Occupational and Environmental Health, Mount Sinai Medical Center, New York, New York, USA., Mitchell EA; Department of Clinical Pathology and Laboratory Medicine, Northwell Health, Little Neck, New York, USA., Lowe W; Department of Occupational and Environmental Medicine, Northwell Health, New Hyde Park, New York, USA., Khare R; Department of Clinical Pathology and Laboratory Medicine, Northwell Health, Little Neck, New York, USA., Tang YW; Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA., Bianchi AL; Employee Health and Wellness Services, Memorial Sloan Kettering Cancer Center, New York, New York, USA., Egan C; Wadsworth Center, New York State Department of Health, Albany, New York, USA., Perry MJ; Wadsworth Center, New York State Department of Health, Albany, New York, USA., Hughes S; Public Health Laboratory, New York City Department of Health and Mental Hygiene, New York, New York, USA., Rakeman JL; Public Health Laboratory, New York City Department of Health and Mental Hygiene, New York, New York, USA., Adams E; Metropolitan Area Regional Office, New York State Department of Health, New Rochelle, New York, USA., Kharod GA; Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Tiller R; Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Saile E; Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Lee S; Public Health Laboratory, New York City Department of Health and Mental Hygiene, New York, New York, USA., Gonzalez E; Public Health Laboratory, New York City Department of Health and Mental Hygiene, New York, New York, USA., Hoppe B; Public Health Laboratory, New York City Department of Health and Mental Hygiene, New York, New York, USA., Leviton IM; Division of Infectious Diseases, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA., Hacker S; Occupational Health Services, Montefiore Medical Center, Bronx, New York, USA., Ni KF; Clinical Laboratory, Richmond University Medical Center, Staten Island, New York, USA., Orsini RL; Department of Clinical Pathology and Laboratory Medicine, Northwell Health, Little Neck, New York, USA., Jhaveri S; Department of Infectious Disease, Long Island Jewish-Forest Hills Hospital/Northwell Health, Forest Hills, New York, USA., Mazariegos I; Department of Clinical Pathology and Laboratory Medicine, Mount Sinai Medical Center, New York, New York, USA., Dingle T; Department of Clinical Pathology and Laboratory Medicine, Mount Sinai Medical Center, New York, New York, USA., Koll B; Infection Prevention and Control, Mount Sinai Beth Israel, New York, New York, USA., Stoddard RA; Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Galloway R; Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Hoffmaster A; Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Fine A; Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, New York, New York, USA., Lee E; Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, New York, New York, USA., Dentinger C; Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, New York, New York, USA., Harrison E; Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, New York, New York, USA., Layton M; Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, New York, New York, USA.
Jazyk:	angličtina
Zdroj:	Journal of clinical microbiology [J Clin Microbiol] 2020 Jan 28; Vol. 58 (2). Date of Electronic Publication: 2020 Jan 28 (Print Publication: 2020).
DOI:	10.1128/JCM.01096-19
Abstrakt:	From 2015 to 2017, 11 confirmed brucellosis cases were reported in New York City, leading to 10 Brucella exposure risk events ( Brucella events) in 7 clinical laboratories (CLs). Most patients had traveled to countries where brucellosis is endemic and presented with histories and findings consistent with brucellosis. CLs were not notified that specimens might yield a hazardous organism, as the clinicians did not consider brucellosis until they were notified that bacteremia with Brucella was suspected. In 3 Brucella events, the CLs did not suspect that slow-growing, small Gram-negative bacteria might be harmful. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), which has a limited capacity to identify biological threat agents (BTAs), was used during 4 Brucella events, which accounted for 84% of exposures. In 3 of these incidents, initial staining of liquid media showed Gram-positive rods or cocci, including some cocci in chains, suggesting streptococci. Over 200 occupational exposures occurred when the unknown isolates were manipulated and/or tested on open benches, including by procedures that could generate infectious aerosols. During 3 Brucella events, the CLs examined and/or manipulated isolates in a biological safety cabinet (BSC); in each CL, the CL had previously isolated Brucella Centers for Disease Control and Prevention recommendations to prevent laboratory-acquired brucellosis (LAB) were followed; no seroconversions or LAB cases occurred. Laboratory assessments were conducted after the Brucella events to identify facility-specific risks and mitigations. With increasing MALDI-TOF MS use, CLs are well-advised to adhere strictly to safe work practices, such as handling and manipulating all slow-growing organisms in BSCs and not using MALDI-TOF MS for identification until BTAs have been ruled out. (Copyright © 2020 American Society for Microbiology.)
Databáze:	MEDLINE
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