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Volume 14, Number 7—July 2008

Online Report

Peer Reviewed Report Available Online Only

Management of Accidental Laboratory Exposure to Burkholderia pseudomallei and B. mallei

Sharon J. Peacock*Comments to Author , Herbert P. Schweizer†, David A.B. Dance‡, Theresa L. Smith§, Jay E. Gee§, Vanaporn Wuthiekanun*, David DeShazer¶, Ivo Steinmetz#, Patrick Tan, and Bart J. Currie††
Author affiliations: *Mahidol University, Bangkok, Thailand; †Colorado State University, Fort Collins, Colorado, USA; ‡Health Protection Agency (South West), Plymouth, UK; §Centers for Disease Control and Prevention, Atlanta, Georgia, USA; ¶US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA; #Universität Greifswald, Greifswald, Germany; **Genome Institute of Singapore, Singapore; ††Menzies School of Health Research and Royal Darwin Hospital, Darwin, Northern Territory, Australia;

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Table 1

Risk assessment of laboratory incidents involving Burkholderia pseudomallei

Low risk
Inadvertent opening of the lid of an agar plate growing B. pseudomallei outside a biologic safety cabinet
Inadvertent sniffing of agar plate growing B. pseudomallei in the absence of contact between worker and bacterium
Splash event leading to visible contact of B. pseudomallei with gloved hand or protected body, in the absence of any evidence of aerosol
Spillage of small volume of liquid culture (<1mL) within a functioning biologic safety cabinet
Contamination of intact skin with culture
High risk
The presence of any predisposing condition without proper personal protective equipment (PPE): diabetes mellitus; chronic liver or kidney disease; alcohol abuse; long-term steroid use; hematologic malignancy; neutropenia or neutrophil dysfunction; chronic lung disease (including cystic fibrosis); thalassemia; any other form of immunosuppression
Needlestick or other penetrating injury with implement contaminated with B. pseudomallei
Bite or scratch by experimental animal infected with B. pseudomallei
Splash event leading to contamination of mouth or eyes
Generation of aerosol outside biologic safety cabinet (e.g., sonication, centrifuge incident)

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