Introduction

Straight-forward information is surprisingly difficult to find

Used to be a typical essay question in FRCPath Part 2 – now likely to morph into short answer questions

Large language models have made this sort of question easier to prepare for

Questions usually involve an incident e.g., spill or handling of cultures on open bench

There can be subtlety in how risk is described – err on side of caution

Immediate actions

Always start by stressing immediate actions to terminate any further exposures

Information gathering

Focus on aerosol-generating high-risk activities

Robust documentation throughout – can get out of hand if collecting information retrospectively

Involve the right teams – H&S, occupational health, laboratory management, UKHSA, etc

Incident teams and meetings particularly if large exposure

Modern one-room laboratory design has complicated management

Incident reporting and learning

Important to highlight ability of lab to review and change practice

Laboratory non-conformity, DATIX, incident report, RIDDOR (HSE)

Most cases arise due to communication breakdown between clinicians and lab

Biosafety cabinets

Class 1 cabinet – focused on protecting user

(Advisory Committe on Dangerous Pathogens 2019)

MALDI-TOF

Procedure itself is relatively safe, but plate set up and disposal involve handling of cultures

Sepsityper can lead to earlier detection and reduce risk

Pathogen specific details

Comments

Where serology indicated, baseline test should be collected and stored

Viruses and protozoa are relatively rare causes

Further reading and references