Laboratory-Acquired Fungal Infections and Biosafety

DOI: 10.6525/TEB.20160510.32(9).002

Yi-Hsuan Shih, Kuo-Wei Chen, Hwa-Jeng Teng, Mei-Hui Liao, Be-Chih, Chen, Ya-Ping Li, Shu-Ying Li

2016 Vol.32 NO.9

Correspondence Author: Shu-Ying Li

  • Center for Research, Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taiwan

Abstract:

In recent years, due to the increase of global migration, climate and environmental change, and immunocompromised population, highly pathogenic and opportunistic fungal diseases are receiving increasing concern in many countries. Hence, it is necessary for laboratory and health care workers to learn about the most frequent fungal laboratory infection accidents, their exposure and transmission routes, as well as potential biosafety risks and the preventive measures. We review laboratory-acquired fungal infections (LFIs) reported in the literature during 1959–2015 and find a total of 398 cases. Among them, dermatophytes constitutes 40.5% and is the most frequent LFIs and occurred mostly in animal experiments. Regarding accidents of handling clinical specimens or fungal culture, the risk group 3 (RG3) dimorphic fungi are the major causative agents, such as Coccidioides spp. (C. immitis or C. posadasii) constituting 28.9%, Histoplasma capsulatum 20.8%. RG2 dimorphic fungi such as Sporothrix schenckii (3.8%), Blastomyces dermatitidis (3.5%), and Penicillium marneffei (0.5%), are also major LFI pathogens. In yeast, Cryptococcus neoformans consisted 2.0% of total LFIs. Infection routes of LFI include animal contacts, needle/sharp injuries, airway inhalation of conidia or infectious aerosol and wound or mucosal contacts etc. In order to protect laboratory workers from getting infected, culturing of the mold form of RG3 dimorphic fungi or handling specimens containing conidia should be done under biosafety level 3(BSL3) or class III biological safety cabinet(class III BSC) environment; animal infection experiment with RG3 fungi should be conducted in animal biosafety level 3(ABSL3) facilities; other experiments dealing with samples containing viable fungi should be done in BSL2 or class II BSC environment. Personal protective equipment should be worn during laboratory experiments. Washing hands and decontamination and disinfection of and laboratory environment are needed after experiments are done.

Keywords:Fungi, Yeast, Mold, Dimorphic fungi, Biosafety levels, Laboratory-acquired infections, Biosafety accidents