02789     2200361   4500001002100000005001500021035002000036007000300056008003900059084001500098100002400113245013100137250002500268260000900293300000800302700002000310700002100330700001600351700002600367700002200393700002300415700002400438700002200462700002400484700002100508700002300529700002100552700002100573700002000594700002000614520174200634856005102376INLIS00000000001875220240207114041  a0010-0224000002ta240207                |          | |    aARTVET23780 aBlacksell, Stuart D1 aLaboratory-acquired infections and pathogen escapes worldwide between 2000 and 2021 :ba scoping review /cBlacksell, Stuart D  aLancet Microbe, 2023  c2023  a1-90 aDhawan, Sandhya0 aKusumoto, Marina0 aLe, Khanh K0 aSummermatter, Kathrin0 aO’Keefe, Joseph0 aKozlovac, Joseph P0 aAlmuhairi, Salama S0 aSendow, Indrawati0 aScheel, Christina M0 aAhumibe, Anthony0 aMasuku, Zibusiso M0 aBennett, Allan M0 aKojima, Kazunobu0 aHarper, David R0 aHamilton, Keith  aLaboratory-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 identi?ed 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 ?ve 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 in?uenza 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.  ahttps://doi.org/10.1016/ S2666-5247(23)00319-1