Laboratory-acquired Infections
A total of nine laboratory-acquired infection events were reported
during the 2006–2016 period in China (Table. 1). Two events were
observed in northern China (Beijing and Ningxia province), and the
remaining seven events were found in southern China (Zhejiang, Jiangsu,
Jiangxi, and Anhui provinces). Seven of them were microbiological
technicians, and the other two were cleaners of a microbiology
laboratory. The age range of the nine cases was 28–65, and the mean age
of 45. Two were males, and seven were females. Five patients were
infected by identifying or handling suspect Brucella strains, two
by handling blood culture samples from patients with brucellosis, and
the remaining individuals were infected while cleaning up the
microbiology laboratory waste. All accidental infections occurred due to
substandard laboratory safety conditions, manipulations outside
biological safety cabinets, or inadequate personal protective equipment.
Fever was the most common clinical manifestation among patients, who
also suffered from fatigue, sweating, joint pain, and headache. Only one
patient was suspected of brucellosis; seven cases were diagnosed with a
fever of unknown origin, and one patient was diagnosed with inflammation
of the psoas major muscle. Eight patients were first diagnosed with
brucellosis by bacteriology test, and a serology test (SAT titer≥1:100)
was used only in one case.
From March to May 2011, a total of 28 individuals (including 27 students
and one teacher) were diagnosed with Brucella infections in the
college of animal medicine of Northeast Agricultural University. The
field epidemiology survey showed that the source of infection were four
goats without the quarantine inspection that experimental animals
require. In December 2010, teachers of
the College of Animal Medicine of
Northeast Agricultural University purchased four goats from a Qingxi
farm, Jijia village, Xingfu Town, Xiangfang District, Harbin city.
However, they did not follow the quarantine and inspection regulations
on the management of experimental animals of the national and
Heilongjiang Province. Subsequently, the four goats infected withBrucella were used for teaching experiments (obstetric experiment
and animal anatomy experiment) five times, involving four teachers, two
experimenters, and 110 students, resulting in the brucellosis infections
in 27 students and one teacher in this college from March to May 2011.
Based on a comprehensive survey and the analysis of the four goats,
these animals (infected with brucellosis) were found to be the source of
infection for these cases. Aerosols and contact with infected goats were
the main route of transmission, and the failure to comply with the
standard experimental norms and ensure that the students would follow
the biosafety protection-operating procedures were the main reason for
this cluster infection events. According to the unified prescription by
the expert Committee on accident handling, the treatment consisted of
intravenous doses of combined doxycycline, rifampin, and levofloxacin
(or etoperidone sulbactam) for six weeks, followed by oral rifapentine
and tetracycline for 40 days. Twenty-five patients were cured, one
patient improved, and two patients still showed a small amount of
effusion in the joint cavity by MRI.