(Note: cette page n'existe qu'en anglais - Nota: deze pagina bestaat enkel in het Engels)

Short introduction

When considering working with pathogenic micro-organisms, it is important to understand a few basic principles about the properties of these micro-organisms and their viability outside the host. To perform a specific risk assessment, the characteristics of the handled organisms and the characteristics of the activity should be considered, in order to apply the suitable containment level, work practices and biosafety equipments aiming at protecting public health and the environment.

Activities involving manipulation of pathogenic micro-organisms (genetically modified or not) are conducted in facilities such as laboratories, animal facilities, greenhouses and production plants. Depending on the type of activity, the human and environmental exposure to the manipulated micro-organism can differ.

Three main types of activities handling pathogenic micro-organisms can be distinguished:

Routine laboratory activities: clinical biology principally performed in human and animal diagnosis laboratories and laboratories for quality control of environment (water,…), food/feed or drugs;
Fundamental and applied research performed by universities, governmental institutions, private companies;
Production essentially carried out in pharmaceutical and biotechnology companies.

For all activities, the handled organism can be involved in contamination of the workers and may cause Laboratory Acquired Infections (LAIs). LAIs are also of public health concern as an infected worker may present a risk of transmission to his colleagues, relatives, family members or other citizens. More information on LAIs can be found on the Belgian Biosafety Server.

If an incident occurs inside a facility, emergency responses should be applied in order to protect workers, public health and the environment. Many factors determine the relevance of emergency responses, and they should preferably be part of a risk assessment. This risk assessment should include but is not limited to specific data about the organism such as the route of exposure, the survival or persistence of the pathogenic micro-organism outside the host, the infectious dose, and the susceptibility to disinfectants.

Route of exposure

The route of exposure indicates how a pathogenic micro-organism can infect human:

Inhalation of infectious aerosols;
Contact with intact skin or through skin lesions;
Percutaneous inoculation (needle and syringe, cuts or abrasions from contaminated items and animal bites);
Contact between mucous membranes and contaminated material (hands or surfaces);
Ingestion (aspiration through a pipette, smoking or eating).

Survival (or persistence) outside the host

A great variability exists regarding the persistence of a micro-organism outside its host. Some pathogenic micro-organisms do not persist outside their host, for others persistence outside the host is unknown. Kramer et al. (2006) concluded from a literature review that “the most common nosocomial pathogens (related to a hospital-acquired infection and often manipulated in diagnostic labs) may well survive or persist on surfaces for months and can represent a continuous source of transmission if no regular preventive surface disinfection is performed”. Low temperatures, approx. 4°C or 6°C, are associated with longer persistence for most bacteria, fungi and viruses. The effect of humidity on individual pathogens is highly variable. Depending on the pathogen, high humidity either increases or decreases survival or even has no discernible effect. Some micro-organisms persist longer on steel, others on plastic, and for some the type of material does not influence their survival. Longer survival times have been described with higher concentrations or titres and/or in the presence of protein, serum, sputum, or without dust.

Infectious dose

The infectious dose is the number of micro-organisms required to cause an infection in the host. Infectious doses may vary as healthy individuals may have other immunity responses than immunocompromised and can sometimes vary from one to hundreds of thousands of units. The host response to infection is highly variable, and is dependent on the interrelationship of many host, agent, and environmental factors. For many pathogenic organisms, infectious doses are not known.

Susceptibility to disinfectants

This document does not aim at providing a total picture of available chemical inactivation methods, but some indications are given to help workers in the choice of a decontamination procedure. Factors that affect the efficacy of surface disinfection include:

The prior cleaning of the object;
The organic and inorganic load;
The type of organism (e.g. lipid enveloped viruses, gram-negative bacteria, spores…) and the degree of microbial contamination;
The concentration and the exposure time to the product;
The physical properties of the object or surface that is contaminated;
The presence of biofilms (biofilms adversely affect the activity of a chemical disinfectant);
The temperature and pH of the disinfection process because these can alter the activity range;
The relative humidity.

Usually a commercially available disinfectant comes with applicable instructions to be followed (e.g., dilution, shelf life, storage, material compatibility, safe use, and disposal).

The aim of this document is to provide a practical tool to help users to perform a proper implementation of emergency procedures. The present table aims at giving some properties of pathogenic micro-organisms that are known as major causative agents of LAIs and of some pathogenic micro-organisms of risk group 3 that are often manipulated in Belgian laboratories. It is important to keep in mind that this table will be subjected to regular updates in response to new scientific knowledge.

Lists of pathogenic micro-organisms

1. Data on the persistence and the susceptibility to disinfectants of some Viruses:

Avian Influenza viruses,Hepatitis A Virus, Hepatitis B Virus, Hepatitis C virus, Human Immunodeficiency viruses, Puumala Hantavirus.

2. Data on the persistence and the susceptibility to disinfectants of some Bacteria:

Bacillus anthracis, Brucella spp., Campylobacter jejuni, Chlamydia psittaci, Clostridium difficile, Coxiella burnetii, E. coli enterohemarragic, Francisella tularensis, Haemophilus influenza, Legionella pneumophila, Mycobacterium tuberculosis, Neisseria meningitidis, Salmonella typhi, Shigella spp., Staphylococcus aureus.

Additionally, we also listed some parasites that are manipulated in laboratories.

3. Data on the persistence and the susceptibility to disinfectants of some parasites :

Cryptosporydium spp., Echinococcus spp., Leishmania spp., Naegleria fowleri, Toxoplasma gondii

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Contained use - Micro-organisms: Viability and susceptibility to disinfectants

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