Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of...

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Biosafety management and rules in microbiological laboratory ความปลอดภัยและระเบียบปฏิบัติในห้องปฏิบัติการจุลชีววิทยา . ดร . นพดล จารูญ

Transcript of Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of...

Page 1: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Biosafety management and rules in microbiological

laboratory

ความปลอดภยและระเบยบปฏบตในหองปฏบตการจลชววทยา

อ.ดร.นพดล จ ารญ

Page 2: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

OUTLINE

Classification of infective microorganisms by risk group (WHO)

Biosafety level (BSL)

Biological safety cabinet (BSC)

Good microbiological technique (GMT)

Decontamination and infectious waste management

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INFECTIOUS AGENT

VIRUS BACTERIA

FUNGUS

Page 4: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

INFECTIOUS AGENT

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Laboratory-Acquired Infection (LAI)

Laboratory CASE %

Research facilities 2,307 58.8

Diagnostic facilities 677 17.3

Biological products (industry) 134 3.4

Teaching facilities 106 2.7

Unspecified 697 17.8

Manual of clinical microbiology 11th edition 2015

Page 6: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Laboratory-Acquired Infection (LAI)

Brucella spp.

Mycobacterium tuberculosis

Francisella tularensis

Enterobacteriaceae (Salmonella spp., Shigella spp., Escherichia coli, Klebsiella spp.)

Clostridium difficile

Neisseria meningitidis

Front Bioeng Biotechnol. 2015; 3: 56

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Laboratory-Acquired Infection (LAI)

Human immunodeficiency virus

Haemorrhagic virus

West Nile virus

Dengue virus

Marburg virus

Front Bioeng Biotechnol. 2015; 3: 56

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Laboratory-Acquired Infection (LAI)

Plasmodium spp.

Leishmania spp.

Trypanosoma spp.

Toxoplasma gondii

Fasciola hepatica

Schistosoma spp.

Clinical Infectious Diseases 2009; 49:142–7

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Laboratory-Acquired Infection (LAI)

Blastomyces dermatitidis

Coccidioides immitis

Histoplasma caspsulatum

Front Bioeng Biotechnol. 2015; 3: 56

Page 10: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Classification of infective microorganisms by risk group (WHO)

Risk Group 1 (no or low individual and

community risk)

Risk Group 2 (moderate individual risk, low

community risk)

Risk Group 3 (high individual risk, low

community risk)

Risk Group 4 (high individual and

community risk)

Page 11: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Classification of infective microorganisms by risk group (WHO)

Risk Group 1 (no or low individual and community risk)

A microorganism that is unlikely to cause human or animal disease.

Group Bacteria Fungi

1 Lactobacillus spp. Saccharomyces cerevisiae

E. coli

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Classification of infective microorganisms by risk group (WHO)

Risk Group 2 (moderate individual risk, low community risk)

A pathogen that can cause human or animal disease but is unlikely to be a serious hazard to laboratory workers, the community, livestock or the environment. Laboratory exposures may cause serious infection, but effective treatment and preventive measures are available and the risk of spread of infection is limited.

Page 13: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Classification of infective microorganisms by risk group (WHO)

Risk Group 2 (moderate individual risk, low community risk)

Group Bacteria Viruses Fungi Parasites

2 Bacillus spp.(not B. anthracis)

Adenovirus Cryptococcus spp. All clinical parasites

Clostridium spp. Calicivirus Candida spp.

Enterobacteriaceae Coronavirus (not CoV)

All dermatophytes

Staphylococcus spp. Herpesvirus Aspergillus spp.

Streptococccus spp. Influenzavirus

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Classification of infective microorganisms by risk group (WHO)

Risk Group 3 (high individual risk, low community risk)

A pathogen that usually causes serious human or animal disease but does not ordinarily spread from one infected individual to another. Effective treatment and preventive measures are available.

Group Bacteria Viruses Fungi

3 Bacillus anthracis HIV Coccidioides immitis

Brucella spp. Hantaan virus Blastomyces dermatitidis

Francisella tularensis Japanese encephalitis virus

Histoplasma capsulatum

Coxiella burnetii West Nile virus Paracoccidioides brasiliensis

Mycobacterium tuberculosis SARS coronavirus

Page 15: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Classification of infective microorganisms by risk group (WHO)

Risk Group 4 (high individual and community risk)

A pathogen that usually causes serious human or animal disease and that can be readily transmitted from one individual to another, directly or indirectly. Effective treatment and preventive measures are not usually available

Group Viruses

4 Ebola virus

Marburg virus

Lassa virus

Page 16: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

BIOSAFETY LEVEL

Biosafety Level 1 (BSL-1)

Biosafety Level 2 (BSL-2)

Biosafety Level 3 (BSL-3)

Biosafety Level 4 (BSL-4)

Page 17: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Biosafety Level 1 (BSL-1)

Laboratory type

– Basic teaching

– Research

Laboratory practices

– Good microbiology

techniques

Safety equipment

– None; open bench work

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Biosafety Level 2 (BSL-2)

Laboratory type

– Diagnostic services

– Research

Laboratory practices

– Good microbiology techniques

– Protective clothing

– Biohazard sign

Safety equipment

– Open bench

– BSC for potential aerosols

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Biosafety Level 3 (BSL-3)

Laboratory type

– Special Diagnostic

– Research

Laboratory practices

– Level2+special clothing

– Controlled access

– Directional airflow

Safety equipment

– Biological safety cabinet (BSC)

– Primary devices for all activities

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Biosafety Level 4 (BSL-4)

Laboratory type

– Dangerous pathogen units

Laboratory practices

– Level3+ airlock entry

– Shower exit

– Special waste disposal

Safety equipment

– BSC class III

– Filtered air

– Double-end autoclave

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Relation of risk groups to biosafety levels, practices and equipment

RISK GROUP BIOSAFETY LEVEL

LABORATORY TYPE LABORATORYPRACTICES

SAFETYEQUIPMENT

1 BSL-1 Basic teaching, research

GMT None; open bench work

2 BSL-2 Primary health services

Diagnostic servicesResearch

GMT + protective clothing, biohazard sign

Open bench + BSC for potialaerosols

3 BSL-3 Special diagnostic services, research

As Level 2 + special clothing,

controlled access, directional airflow

BSC and/or other primary devices for all activities

4 BSL-4 Dangerous pathogen unit As Level 3 +

Airlock entry, shower exit,special waste disposal

BSC class III

Or positive pressure suit in

conjunction with BSC class II,

double ended autoclave (through the wall), filtered air

Page 22: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

BIOSAFETY LEVEL IN THAILAND

BSL-1 BSL-2

BSL-3 BSL-4? ?BSL-4

Page 23: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

ENHANCED BSL-2

“Enhanced BSL-2 condition”

(BSL-2+)

BSL-2 เสมอนเปน BSL-3

โดยการปฏบตงานทกขนตอนกบตวอยางสงตรวจ ตองท าในตปลอดเชอนรภย (Biosafety cabinet:BSC) เทานน

Page 24: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Biological safety cabinet (BSC)

BSCs are designed to provide personnel, environmental and product (work materials) protection

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Aerosol particles are created by

Shaking, pouring, stirring or dropping liquid onto a surface or into another liquid

Streaking agar plates

Inoculating cell culture flasks with a pipette

Using a multichannel pipette to dispense liquid suspensions of infectious agents into microculture plates

Homogenizing and vortexing infectious materials

Centrifugation of infectious liquids

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High Efficiency Particulate Air (HEPA) Filter

HEPA filters remove the most penetrating particle size (MPPS) of 0.3 μm with an efficiency of at least 99.97%

The typical HEPA filter medium is a single sheet of borosilicate fibers treated with a wet-strength water-repellant binder

Bacteria, spores and viruses are removed from the air by these filters

Page 27: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

High Efficiency Particulate Air (HEPA) Filter

Page 28: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Biological safety cabinet

Class I

Class II A1

Class II A2

Class II B1

Class II B2

Class III

Page 29: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Class I BSC

The Class I BSC provides personnel and environmental protection, but no product protection.

Bailey&Scott’s Diagnostic Microbiology 13th edition, 2014

Page 30: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Class II BSC

The Class II (Types A1, A2, B1 and B2) BSCs provide personnel, environmental and product protection.

Type A1 and A2 BSCs may be recirculated to the laboratory or discharged from the building via a canopy or “thimble” connected to the building exhaust.

Types B1 and B2 BSCs must be discharged directly to the outdoors via a hard connection (exhaust air).

Page 31: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Class II BSC Type A1, A2

A1 A2

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Class II BSC Type B1, B2

B1 B2

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Class II BSC

Bailey&Scott’s Diagnostic Microbiology 13th edition, 2014

Page 34: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Class III BSC

Class III BSC was designed for work with highly infectious microbiological agents.

Enclosure with a non-opening view window.

Access for passage of materials into the cabinet is through a dunk tank.

Double-door pass-through box (e.g., an autoclave) that can be decontaminated between uses.

Both supply and exhaust air are HEPA filtered on a Class III cabinet.

Exhaust air must pass through two HEPA filters.

Page 35: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Class III BSC

Page 36: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Class III BSC

Bailey&Scott’s Diagnostic Microbiology 13th edition, 2014

Page 37: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Selection of a Safety Cabinet through Risk Assessment

Page 38: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Laminar Flow “Clean Bench”

Page 39: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

A typical layout for working “clean to dirty” within a Class II BSC. Clean cultures (left) can be inoculated (center)

Page 40: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Biological safety cabinet class II, III

http://www.etelstar.com/en/communications/news/high+containment+biological+safety+cabinet.htm

Page 41: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

www.medicalexpo.comwww.ices.a-star.edu.sg

1

2

3 1= Fume hood2= laminar flow3= Biosafety cabinet

Page 42: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Good Microbiological Technique (GMT)

เทคนคทดทางจลชววทยา

หองปฏบตการตองมการจ ากดการเขาออกส าหรบบคคลทไมเกยวของ กรณมผมาเยอนตองมการจดบนทกรายละเอยด และตองมผดแลตลอดเวลาทอยในพนทหองปฏบตการ

ควรมการท าความสะอาดอยางนอยหนงครงตอหนงวน ภายหลงการเสรจสนการปฏบตงานและหลงจากมส งสงตรวจหกหลน

ขยะหรอของเสยทตดเชอ จะตองมการลดการปนเปอนกอนน าออกจากพนทหรอหองปฏบตการหรอน าไปทง (Decontamination)

หามใชปากในการดดปเปตเพอดดของเหลวหรอสงสงตรวจ

Page 43: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Good Microbiological Technique (GMT)

เทคนคทดทางจลชววทยา

หามรบประทานอาหาร เครองดม สบบหร แตงหนา และใสคอนแทคเลนสในหองปฏบตการ

หามเกบอาหารหรอสงทไมเกยวของกบการปฏบตการในตเยนส าหรบเกบสงสงตรวจ และน ายาตรวจตางๆ

ตองลางมอทกคร งหลงสมผสกบสงสงตรวจ และเมอจะออกจากหองปฏบตการ

ในการปฏบตงานตองระวงการกอใหเกดการฟ งกระจายของสงสงตรวจ เชนการปนเหวยง การเขยา การผสม การเปดภาชนะ ควรท าในตชวนรภยเสมอ

Page 44: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Good Microbiological Technique (GMT)

เทคนคทดทางจลชววทยา

ผปฏบตงานทกคนตองใสอปกรณปองกนอนตรายเฉพาะบคคล ไดแก เสอกาวน ถงมอ และแวนตานรภย

ตองระมดระวงของมคม เขม แกว อาจกอใหเกดการทม การบาด การแตก ระหวางปฏบตงาน และตองทงในถงขยะส าหรบทงของมคมเทานน

เมอมการหกหลนหรออบตเหตใดๆ ทเกดขนในหองปฏบตการตองรายงานตอหวหนาหองปฏบตการและตองมการลงบนทกเสมอ

ในหองปฏบตการควรมตนงฆาเชอภายใตความดน (Autoclave) ส าหรบอปกรณและขยะตดเชอจากหองปฏบตการ

Page 45: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Good Microbiological Technique (GMT)

เทคนคทดทางจลชววทยา

Page 46: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

BIOLOGICAL HAZARD SIGN

Page 47: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Decontamination and infectious waste management

ขยะทเปนสารคดหลง เชนเลอด สวนประกอบของเลอด ปสสาวะ อจจาระ น าไขสนหลง เสมหะ และสารคดหลงตาง ๆ

รวมทงวสดอปกรณทางการแพทยตางๆ ผา สงของตางๆ ทเปอนเลอดหรอสารคดหลงตางๆ

ใสถงพลาสตกแดง

Page 48: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Decontamination and infectious waste management

ขยะของมคมตดเชอทใชแลว เชน เขม ใบมด และเครองมอทแหลมคมตาง ๆ ทใชกบผปวยแลว

Page 49: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Decontamination and infectious waste management

ขยะจากระบวนการเกบและเพาะเชอ เชน เชอ อาหารเลยงเชอ จากเลยงเชอ วสดอน และเครองมอทใชเพาะเชอแลว

Page 50: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

Decontamination and infectious waste management

อปกรณหรอวสดปนเปอนสารคดหลงจากผปวย ควรแชน ายาฆาเชอเชน 0.5% hypochlorite ประมาณ 30 นาทขนไป แลวลางจากนน autoclave เพอน ากลบมาใชใหม

Page 51: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

AUTOCLAVE

Steam under pressure

121oC, 15 min, 15 psi

Sterilizes and kills endospores

Page 52: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

AUTOCLAVE

Bacillus stearothermophilus

Sterilization test, spore test

http://www.phtnet.org/equipment/http://www.autoclavesporetesting.com/InOfficeDailyTestingBroch.pdf

Page 53: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

การลางมอ

Page 54: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

ความปลอดภยและระเบยบปฏบตในหองปฏบตการจลชววทยา

สต

Page 55: Biosafety management and rules in microbiological laboratory · 2016-05-12 · Classification of infective microorganisms by risk group (WHO) Risk Group 2 (moderate individual risk,

References

Manual of clinical microbiology, 11th edition (ASM), 2015

Laboratory biosafety manual, WHO 2004

Bailey&Scott’s Diagnostic Microbiology 13th edition, 2014

ความปลอดภยและความมนคงทางชวภาพ ส าหรบหองปฏบตการทางการแพทยและสตวแพทย, สมาคมชวนรภย (ประเทศไทย)

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