Analysis of risk factors for laboratory-acquired brucella infections O ¨ . Ergo ¨nu¨l a, *, A. C ¸elikbas ¸ a , D. Tezeren b , E. Gu ¨vener b , B. Dokuzog ˘uz a a The First Infectious Diseases and Clinical Microbiology Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey b The First Microbiology and Clinical Microbiology Laboratory, Ankara Numune Education and Research Hospital, Ankara, Turkey Received 19 July 2003; accepted 23 December 2003 KEYWORDS Laboratory-acquired; Brucella infection; Risk factors Summary The aim of the study was to determine the risk factors for acquiring brucella infection among healthcare workers (HCWs). The study was performed in Ankara Numune Education and Research Hospital, Turkey, before the introduction of Biosafety III measures. A questionnaire was given to HCWs, who were at risk of brucella infection. Twelve HCWs with brucella infection were detected, an incidence of 8% per employee-year. A multi- variate analysis of risk factors in seven of the cases and 48 control HCWs was performed. Male physicians were found to be associated with a higher risk of acquiring brucella infection [odds ratio, 25.3; confidence interval (CI), 2.3 – 283.7; P ¼ 0:008]. Using gloves was found to be protective (odds ratio, 0.02; CI, 0.008 – 0.4; P ¼ 0:017). Q 2004 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved. Introduction Brucella spp. are a leading cause of laboratory- acquired bacterial infections, 1 and have been reported in both brucella-endemic and brucella- free countries since 1941. 2–5 Laboratory-associated infections represent 2% of all reported cases of brucellosis, 1–6 demonstrating the high risk of acquiring brucella infection in clinical microbiology laboratories where these highly infective bacteria are handled. Transmission occurs usually via inhalation of bacteria, allowing entry of brucella through the respiratory mucosa. 1–5 Transmission routes other than aerosol inhalation have been defined, although some of them are speculative. The risk factors for acquisition of infection among healthcare workers (HCWs) have not been pre- viously reported. Brucellosis is endemic in Turkey, and as a consequence, the inhalation route of transmission among microbiology laboratory workers is import- ant. However, laboratory-acquired infections are rarely diagnosed or reported. The Occupational Health and Safety Committee in our hospital targeted the control of laboratory-acquired infections in HCWs. This study presents clinical and laboratory findings of laboratory-acquired 0195-6701/$ - see front matter Q 2004 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.jhin.2003.12.020 Journal of Hospital Infection (2004) 56, 223–227 www.elsevierhealth.com/journals/jhin * Corresponding author. Address: Guvenlik caddesi 17/10, 06540 Asagi Ayranci, Ankara, Turkiye. Tel. þ 90-312-4194227. E-mail addresses: oergonul@hotmail.com; mergonul@hsph. harvard.edu