Biosafety Level 3 Laboratory for Autopsies of Patients with Severe Acute Respiratory Syndrome: Principles, Practices, and Prospects
Identifieur interne : 000667 ( Istex/Curation ); précédent : 000666; suivant : 000668Biosafety Level 3 Laboratory for Autopsies of Patients with Severe Acute Respiratory Syndrome: Principles, Practices, and Prospects
Auteurs : Ling Li [République populaire de Chine] ; Jiang Gu [République populaire de Chine] ; Xicheng Shi [République populaire de Chine] ; Encong Gong [République populaire de Chine] ; Xingwang Li [République populaire de Chine] ; Hongquan Shao [République populaire de Chine] ; Xueying Shi [République populaire de Chine] ; Huijun Jiang [République populaire de Chine] ; Xiaoqiang Gao [République populaire de Chine] ; Daiyun Cheng [République populaire de Chine] ; Lizhu Guo [République populaire de Chine] ; Hao Wang [République populaire de Chine] ; Xiaohong Shi [République populaire de Chine] ; Peizhi Wang [République populaire de Chine] ; Qianying Zhang [République populaire de Chine] ; Bing Shen [République populaire de Chine]Source :
- Clinical Infectious Diseases [ 1058-4838 ] ; 2005.
Abstract
Background. During the outbreak of the emergent severe acute respiratory syndrome (SARS) infection, >30% of the ∼8000 infected persons were health care workers. The highly infectious nature of SARS coronavirus (SARS-CoV) compelled our pathologists to consider biosafety issues in the autopsy room and for tissue processing procedures. Methods. A specially designed biosafety level 3 (BSL-3) autopsy laboratory was constructed and divided into a clean area, a semicontaminated area, a contaminated area, and 2 buffer zones. High-efficiency particulate air filters were placed in the air supply and exhaust systems. Laminar air flow was from the clean areas to the less clean areas. The negative pressures of the contaminated, semicontaminated, and clean areas were approximately -50 pa, -25 pa, and -5 pa, respectively. Personal protective equipment, including gas mask, impermeable protective clothing, and 3 layers of gloves worn during autopsies; the equipment was decontaminated before it was allowed to exit the facility. Strict BSL-3 practices were followed. Results. When a given concentration of particulate sarin simulant was introduced into the contaminated area, it could not be detected in either the semicontaminated area or clean area, and particles >0.3 μm in size were not detected in the exhaust air. A total of 16 complete postmortem examinations for probable and suspected SARS were performed during a 2-month period. Of these, 7 reported confirmed cases of SARS. None of the 23 pathologists and technicians who participated in these autopsies was infected with SARS-CoV. Conclusions. Our experience suggests that BSL-3 laboratory operating principles should be among the special requirements for performing autopsies of contaminated bodies and that they can safeguard the clinicians and the environment involved in these procedures.
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DOI: 10.1086/432720
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China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Pathology, Health Science Center, School of Basic Medical Sciences, Peking University, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Shi, Xicheng" sort="Shi, Xicheng" uniqKey="Shi X" first="Xicheng" last="Shi">Xicheng Shi</name><affiliation wicri:level="1"><mods:affiliation>Research Institute of Chemical Defense, and Beijing Ditan Hospital, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Research Institute of Chemical Defense, and Beijing Ditan Hospital, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Gong, Encong" sort="Gong, Encong" uniqKey="Gong E" first="Encong" last="Gong">Encong Gong</name><affiliation wicri:level="1"><mods:affiliation>Department of Pathology, Health Science Center, School of Basic Medical Sciences, Peking University, Beijing, 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wicri:level="1"><mods:affiliation>Department of Pathology, Health Science Center, School of Basic Medical Sciences, Peking University, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Pathology, Health Science Center, School of Basic Medical Sciences, Peking University, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Jiang, Huijun" sort="Jiang, Huijun" uniqKey="Jiang H" first="Huijun" last="Jiang">Huijun Jiang</name><affiliation wicri:level="1"><mods:affiliation>Department of Pathology, Health Science Center, School of Basic Medical Sciences, Peking University, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Pathology, Health Science Center, School of Basic Medical Sciences, Peking University, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Gao, Xiaoqiang" sort="Gao, Xiaoqiang" uniqKey="Gao X" first="Xiaoqiang" last="Gao">Xiaoqiang Gao</name><affiliation wicri:level="1"><mods:affiliation>Research Institute of Chemical Defense, and Beijing Ditan Hospital, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Research Institute of Chemical Defense, and Beijing Ditan Hospital, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Cheng, Daiyun" sort="Cheng, Daiyun" uniqKey="Cheng D" first="Daiyun" last="Cheng">Daiyun Cheng</name><affiliation wicri:level="1"><mods:affiliation>Research Institute of Chemical Defense, and Beijing Ditan Hospital, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Research Institute of Chemical Defense, and Beijing Ditan Hospital, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Guo, Lizhu" sort="Guo, Lizhu" uniqKey="Guo L" first="Lizhu" last="Guo">Lizhu Guo</name><affiliation wicri:level="1"><mods:affiliation>Beijing Ditan Hospital, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Beijing Ditan Hospital, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Wang, Hao" sort="Wang, Hao" uniqKey="Wang H" first="Hao" last="Wang">Hao Wang</name><affiliation wicri:level="1"><mods:affiliation>Beijing Ditan Hospital, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Beijing Ditan Hospital, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Shi, Xiaohong" sort="Shi, Xiaohong" uniqKey="Shi X" first="Xiaohong" last="Shi">Xiaohong Shi</name><affiliation wicri:level="1"><mods:affiliation>Beijing Ditan Hospital, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Beijing Ditan Hospital, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Wang, Peizhi" sort="Wang, Peizhi" uniqKey="Wang P" first="Peizhi" last="Wang">Peizhi Wang</name><affiliation wicri:level="1"><mods:affiliation>Beijing Ditan Hospital, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Beijing Ditan Hospital, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Zhang, Qianying" sort="Zhang, Qianying" uniqKey="Zhang Q" first="Qianying" last="Zhang">Qianying Zhang</name><affiliation wicri:level="1"><mods:affiliation>Beijing Ditan Hospital, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Beijing Ditan Hospital, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Shen, Bing" sort="Shen, Bing" uniqKey="Shen B" first="Bing" last="Shen">Bing Shen</name><affiliation wicri:level="1"><mods:affiliation>Beijing Ditan Hospital, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Beijing Ditan Hospital, Beijing</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:B39AB8E2C19DFBF408646CF79BC96BA923D088DB</idno><date when="2005" year="2005">2005</date><idno type="doi">10.1086/432720</idno><idno type="url">https://api.istex.fr/ark:/67375/HXZ-R9CTJ7LK-6/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">000667</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000667</idno><idno type="wicri:Area/Istex/Curation">000667</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main">Biosafety Level 3 Laboratory for Autopsies of Patients with Severe Acute Respiratory Syndrome: Principles, Practices, and Prospects</title><author><name sortKey="Li, Ling" sort="Li, Ling" uniqKey="Li L" first="Ling" last="Li">Ling Li</name><affiliation wicri:level="1"><mods:affiliation>Department of Pathology, Health Science Center, School of Basic Medical Sciences, Peking University, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Pathology, Health Science Center, School of Basic Medical Sciences, Peking University, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Gu, Jiang" sort="Gu, Jiang" uniqKey="Gu J" first="Jiang" last="Gu">Jiang Gu</name><affiliation wicri:level="1"><mods:affiliation>Department of Pathology, Health Science Center, School of Basic Medical Sciences, Peking University, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Pathology, Health Science Center, School of Basic Medical Sciences, Peking University, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Shi, Xicheng" sort="Shi, Xicheng" uniqKey="Shi X" first="Xicheng" last="Shi">Xicheng Shi</name><affiliation wicri:level="1"><mods:affiliation>Research Institute of Chemical Defense, and Beijing Ditan Hospital, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Research Institute of Chemical Defense, and Beijing Ditan Hospital, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Gong, Encong" sort="Gong, Encong" uniqKey="Gong E" first="Encong" last="Gong">Encong Gong</name><affiliation wicri:level="1"><mods:affiliation>Department of Pathology, Health Science Center, School of Basic Medical Sciences, Peking University, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Pathology, Health Science Center, School of Basic Medical Sciences, Peking University, Beijing</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>E-mail: pathcon@bjmu.edu.cn</mods:affiliation><country wicri:rule="url">République populaire de Chine</country></affiliation><affiliation wicri:level="1"><mods:affiliation>Reprints or correspondence: Dr. Encong Gong, Dept. of Pathology, School of Basic Medical Sciences, Peking University, 38 Xueyuan Rd., Beijing, China 100083 (pathcon@bjmu.edu.cn).</mods:affiliation><country wicri:rule="url">République populaire de Chine</country><wicri:regionArea>Reprints or correspondence: Dr. Encong Gong, Dept. of Pathology, School of Basic Medical Sciences, Peking University, 38 Xueyuan Rd., Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Li, Xingwang" sort="Li, Xingwang" uniqKey="Li X" first="Xingwang" last="Li">Xingwang Li</name><affiliation wicri:level="1"><mods:affiliation>Beijing Ditan Hospital, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Beijing Ditan Hospital, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Shao, Hongquan" sort="Shao, Hongquan" uniqKey="Shao H" first="Hongquan" last="Shao">Hongquan Shao</name><affiliation wicri:level="1"><mods:affiliation>Department of Pathology, Health Science Center, School of Basic Medical Sciences, Peking University, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Pathology, Health Science Center, School of Basic Medical Sciences, Peking University, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Shi, Xueying" sort="Shi, Xueying" uniqKey="Shi X" first="Xueying" last="Shi">Xueying Shi</name><affiliation wicri:level="1"><mods:affiliation>Department of Pathology, Health Science Center, School of Basic Medical Sciences, Peking University, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Pathology, Health Science Center, School of Basic Medical Sciences, Peking University, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Jiang, Huijun" sort="Jiang, Huijun" uniqKey="Jiang H" first="Huijun" last="Jiang">Huijun Jiang</name><affiliation wicri:level="1"><mods:affiliation>Department of Pathology, Health Science Center, School of Basic Medical Sciences, Peking University, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Pathology, Health Science Center, School of Basic Medical Sciences, Peking University, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Gao, Xiaoqiang" sort="Gao, Xiaoqiang" uniqKey="Gao X" first="Xiaoqiang" last="Gao">Xiaoqiang Gao</name><affiliation wicri:level="1"><mods:affiliation>Research Institute of Chemical Defense, and Beijing Ditan Hospital, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Research Institute of Chemical Defense, and Beijing Ditan Hospital, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Cheng, Daiyun" sort="Cheng, Daiyun" uniqKey="Cheng D" first="Daiyun" last="Cheng">Daiyun Cheng</name><affiliation wicri:level="1"><mods:affiliation>Research Institute of Chemical Defense, and Beijing Ditan Hospital, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Research Institute of Chemical Defense, and Beijing Ditan Hospital, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Guo, Lizhu" sort="Guo, Lizhu" uniqKey="Guo L" first="Lizhu" last="Guo">Lizhu Guo</name><affiliation wicri:level="1"><mods:affiliation>Beijing Ditan Hospital, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Beijing Ditan Hospital, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Wang, Hao" sort="Wang, Hao" uniqKey="Wang H" first="Hao" last="Wang">Hao Wang</name><affiliation wicri:level="1"><mods:affiliation>Beijing Ditan Hospital, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Beijing Ditan Hospital, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Shi, Xiaohong" sort="Shi, Xiaohong" uniqKey="Shi X" first="Xiaohong" last="Shi">Xiaohong Shi</name><affiliation wicri:level="1"><mods:affiliation>Beijing Ditan Hospital, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Beijing Ditan Hospital, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Wang, Peizhi" sort="Wang, Peizhi" uniqKey="Wang P" first="Peizhi" last="Wang">Peizhi Wang</name><affiliation wicri:level="1"><mods:affiliation>Beijing Ditan Hospital, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Beijing Ditan Hospital, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Zhang, Qianying" sort="Zhang, Qianying" uniqKey="Zhang Q" first="Qianying" last="Zhang">Qianying Zhang</name><affiliation wicri:level="1"><mods:affiliation>Beijing Ditan Hospital, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Beijing Ditan Hospital, Beijing</wicri:regionArea></affiliation></author><author><name sortKey="Shen, Bing" sort="Shen, Bing" uniqKey="Shen B" first="Bing" last="Shen">Bing Shen</name><affiliation wicri:level="1"><mods:affiliation>Beijing Ditan Hospital, Beijing, China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Beijing Ditan Hospital, Beijing</wicri:regionArea></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Clinical Infectious Diseases</title><title level="j" type="abbrev">Clinical Infectious Diseases</title><idno type="ISSN">1058-4838</idno><idno type="eISSN">1537-6591</idno><imprint><publisher>The University of Chicago Press</publisher><date type="published">2005</date><biblScope unit="vol">41</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="815">815</biblScope><biblScope unit="page" to="821">821</biblScope></imprint><idno type="ISSN">1058-4838</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1058-4838</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Background. During the outbreak of the emergent severe acute respiratory syndrome (SARS) infection, >30% of the ∼8000 infected persons were health care workers. The highly infectious nature of SARS coronavirus (SARS-CoV) compelled our pathologists to consider biosafety issues in the autopsy room and for tissue processing procedures. Methods. A specially designed biosafety level 3 (BSL-3) autopsy laboratory was constructed and divided into a clean area, a semicontaminated area, a contaminated area, and 2 buffer zones. High-efficiency particulate air filters were placed in the air supply and exhaust systems. Laminar air flow was from the clean areas to the less clean areas. The negative pressures of the contaminated, semicontaminated, and clean areas were approximately -50 pa, -25 pa, and -5 pa, respectively. Personal protective equipment, including gas mask, impermeable protective clothing, and 3 layers of gloves worn during autopsies; the equipment was decontaminated before it was allowed to exit the facility. Strict BSL-3 practices were followed. Results. When a given concentration of particulate sarin simulant was introduced into the contaminated area, it could not be detected in either the semicontaminated area or clean area, and particles >0.3 μm in size were not detected in the exhaust air. A total of 16 complete postmortem examinations for probable and suspected SARS were performed during a 2-month period. Of these, 7 reported confirmed cases of SARS. None of the 23 pathologists and technicians who participated in these autopsies was infected with SARS-CoV. Conclusions. Our experience suggests that BSL-3 laboratory operating principles should be among the special requirements for performing autopsies of contaminated bodies and that they can safeguard the clinicians and the environment involved in these procedures.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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