Biosafety measures required for CBNAAT

It is essential to follow biosafety protocols while handling specimens and cartridges. This will prevent anyone handling the specimens and cartridges from getting infected.

General Biosafety Requirements for CBNAAT

Cartridge-based Nucleic Acid Amplification Test (CBNAAT) is a low-risk procedure and requires the same level of precautions, like those used for direct Acid-fast Bacillus (AFB) sputum smear microscopy:

1. Carry out the procedure in a well-ventilated area.
2. Wear gloves and a laboratory coat at all times when handling patient samples.
3. Minimize the generation of aerosols during sample processing and handle specimens carefully and responsibly.

Based on risk assessment, additional biosafety precautions may be required in CBNAAT laboratories, such as the use of N95 respirators or biosafety cabinets.

Personal Protective Equipment (PPE) is important, but it does not replace good microbiological and good laboratory practices. They include:

Gloves: Essential (disposable and powder-free)

Laboratory coats: Essential

Respirators: Usually not required, but:

• May be needed, based on risk assessment.
• Must always be included in a spill kit.
• Recommended respirators are N95 or chosen based on program guidelines.

Precautions to take while preparing samples for CBNAAT testing

• The sample reagent should be added to the specimen in such a manner that the procedure minimizes aerosol generation.
• Although the sample reagent inactivates M. tuberculosis bacilli, it reduces, but does not eliminate, the biosafety risk to the laboratory technician.
• There is an increased risk of generating aerosols when splitting and handling concentrated and extrapulmonary TB specimens. These procedures must be performed in a certified biosafety cabinet.

Precautions during cartridge loading and transport

• When transferring cartridges to the machine for loading, an appropriate size enclosed container should be used.
• Care should be taken, as samples may leak if the cartridges are toppled during transport.

Resources

• GeneXpert MTB/RIF Assay Package Insert.

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