Abstract：
Laboratory-acquired infections (LAIs) and accidental pathogen escape from laboratory settings (APELS) are major concerns for the community. A risk-based approach for pathogen research management within a standard biosafety management framework is recommended but is challenging due to reasons such as inconsistency in risk tolerance and perception. Here, we performed a scoping review using publicly available, peer-reviewed journal and media reports of LAIs and instances of APELS between 2000 and 2021. We identified LAIs in 309 individuals in 94 reports for 51 pathogens. Eight fatalities (2·6% of all LAIs) were caused by infection with Neisseria meningitidis (n=3, 37·5%), Yersinia pestis (n=2, 25%), Salmonella enterica serotype Typhimurium (S Typhimurium; n=1, 12·5%), or Ebola virus (n=1, 12·5%) or were due to bovine spongiform encephalopathy (n=1, 12·5%). The top five LAI pathogens were S Typhimurium (n=154, 49·8%), Salmonella enteritidis (n=21, 6·8%), vaccinia virus (n=13, 4·2%), Brucella spp (n=12, 3·9%), and Brucella melitensis (n=11, 3·6%). 16 APELS were reported, including those for Bacillus anthracis, SARS-CoV, and poliovirus (n=3 each, 18·8%); Brucella spp and foot and mouth disease virus (n=2 each, 12·5%); and variola virus, Burkholderia pseudomallei, and influenza virus H5N1 (n=1 each, 6·3%). Continual improvement in LAI and APELS management via their root cause analysis and thorough investigation of such incidents is essential to prevent future occurrences. The results are biased due to the reliance on publicly available information, which emphasises the need for formalised global LAIs and APELS reporting to better understand the frequency of and circumstances surrounding these incidents.
摘要：
实验室获得性感染（LAI）和实验室环境中的意外病原体逃逸（APELS）是社区的主要关注点。建议在标准生物安全管理框架内采用基于风险的病原体研究管理方法，但由于风险承受能力和感知不一致等原因而具有挑战性。这里,我们使用公开的方法进行了范围审查，2000年至2021年间对LAIs和APELS实例的同行评审期刊和媒体报道。我们在94份报告中的309名个体中鉴定了51种病原体的LAI。8例死亡（占所有LAIs的2·6％）是由脑膜炎奈瑟菌感染引起的（n=3，37·5％），鼠疫耶尔森氏菌（n=2，25%），沙门氏菌血清型鼠伤寒（鼠伤寒沙门氏菌；n=1，12·5％），或埃博拉病毒（n=1，12·5％）或由于牛海绵状脑病（n=1，12·5％）。LAI前五名病原菌为鼠伤寒沙门氏菌(n=154，49·8%)，肠炎沙门氏菌（n=21，6·8%），痘苗病毒（n=13，4·2%），布鲁氏菌属（n=12，3·9%），和布鲁氏菌(n=11，3·6%)。报告了16例APELS，包括炭疽杆菌,SARS-CoV,和脊髓灰质炎病毒(每个n=3，18·8%)；布鲁氏菌和口蹄疫病毒(n=2，12·5%)；和天花病毒，假伯克霍尔德菌,和流感病毒H5N1（n=1，6·3%）。通过根本原因分析和对此类事件的彻底调查，持续改进LAI和APELS管理对于防止未来发生至关重要。由于对公开信息的依赖，结果存在偏见，强调需要正式的全球LAI和APELS报告，以更好地了解这些事件的频率和情况。
