Cerebrospinal fluid protein and glucose examinations and tuberculosis: Will laboratory safety regulations force a change of practice?
- PMID: 26526598
- PMCID: PMC4622191
- DOI: 10.11613/BM.2015.035
Cerebrospinal fluid protein and glucose examinations and tuberculosis: Will laboratory safety regulations force a change of practice?
Abstract
Cerebrospinal fluid (CSF) protein and glucose examinations are usually performed in chemical pathology departments on autoanalysers. Tuberculosis (TB) is a group 3 biological agent under Directive 2000/54/EC of the European Parliament but in the biochemistry laboratory, no extra precautions are taken in its analysis in possible TB cases. The issue of laboratory practice and safety in the biochemical analyses of CSF specimens, when tuberculosis infection is in question is addressed in the context of ambiguity in the implementation of current national and international health and safety regulations. Additional protective measures for laboratory staff during the analysis of CSF TB samples should force a change in current laboratory practice and become a regulatory issue under ISO 15189. Annual Mantoux skin test or an interferon-γ release assay for TB should be mandatory for relevant staff. This manuscript addresses the issue of biochemistry laboratory practice and safety in the biochemical analyses of CSF specimens when tuberculosis infection is in question in the context of the ambiguity of statutory health and safety regulations.
Keywords: accreditation; cerebrospinal fluid; glucose; proteins; safety; tuberculosis.
Conflict of interest statement
None declared.
References
-
- Karcher S. McPherson RA. Cerebrospinal, synovial, serous body fluids, and alternative specimens. In. Henry’s clinical diagnosis and management by laboratory methods. 22ed. McPherson RA, Pincus MR Eds. Elsevier Saunders Philadelphia. 2011; Ch 29, 480-506.
-
- Patel VB, Burger I, Connolly C. Temporal evolution of cerebrospinal fluid following initiation of treatment for tuberculous meningitis. S Afr Med J. 2008;98:610–3. - PubMed
-
- Safety, health and welfare at work (Biological agents) Regulations 2013. SI number 572 of 2013. Stationary Office, Government Publications. Dublin. Available at: http://www.hsa.ie/eng/Legislation/New_Legislation/Biological%20Agents%20.... Accessed April 27, 2015.
-
- Safety Health and Welfare (Biological Agents) Regulations 2013. Schedule 2. Irish Statute Book. Available at: http://www.irishstatutebook.ie/2013/en/si/0572.html. Accessed April 27, 2015.
-
- Canadian Tuberculosis Standards. Public Health Agency of Canada. The Lung Association. Canadian Thoracic Society. 7th Edition. 2014. Available at: http://tbevidence.org/wp-content/uploads/2014/04/Canadian_TB_Standards_7.... Accessed December 1st, 2014.
