A Literature Review of Laboratory-Acquired Brucellosis
Brucellosis is a bacterial zoonotic disease which has been associated with laboratory-acquired infections. No recent reviews have addressed the characteristics of laboratory-acquired brucellosis (LAB). English-language literature was reviewed to identify reports of laboratory exposures to Brucella spp. and LAB cases between 1982 and 2007. Evaluation of twenty-eight case reports identified 167 potentially exposed laboratory workers of which 71 had LAB. Nine reports were identified that summarized an additional 186 cases of LAB. Only 18 (11%) exposures were due to laboratory accidents, 147 (88%) exposures were due to aerosolization of organisms during routine identification activities and 2 (1%) exposures were unknown. Brucella melitensis was the causative agent for 80% (135/167) of the exposures. Workers with high risk exposures were 9.3 times more likely to develop LAB than workers with low risk exposures (95% CI, 3.0-38.6; P<0.0001); they were also 0.009 times as likely to develop LAB if they took antimicrobial PEP than those who did not take PEP (95% CI, 0-0.042; P<0.0001). Median incubation period in case and summary reports was eight weeks (range 1-40 weeks). Antimicrobial PEP is effective in preventing LAB. The incubation period may be used to identify appropriate serological and symptom surveillance timeframes for exposed laboratory workers.
Traxler RM, Lehman MW, Bosserman EA, Guerra MA, Smith TL. A Literature Review of Laboratory-Acquired Brucellosis. J Clin Microbiol. 2013 Jul 3. Pay-per-view