One Bad Apple Can Spoil the Bunch: The Impact of Contamination in the Clinical Laboratory.

Abstract

Laboratory contamination is a relatively broad, diverse, and often overlooked concern in the clinical laboratory. All clinical specimens have the potential to harbor infectious disease such as HIV and pose a potential risk to laboratory workers. However, the term “laboratory contamination” also encompasses the potential impact of the laboratory on the analysis of a specimen. For example, contamination may be introduced by laboratory staff or from carryover from another specimen. As a result, laboratory contamination may have serious and widespread negative impacts on both diagnostic testing and laboratory staff. With regards to testing, if not identified early, the impacts can extend far beyond an individual patient’s sample, possibly jeopardizing the integrity of a multitude of patient samples and instruments. Despite routine quality control (QC) procedures, the number and types of contamination events in the clinical laboratory are unknown and generally not reported. Further, investigation into the source of contamination can be time and cost intensive, involving methods such as precision studies, instrument service and replacement of parts, airflow analysis, assessing water purification systems, environmental dust sampling, and development of methods for monitoring and cleaning. Measures to decontaminate the laboratory and impacted equipment are both cost and labor intensive. Despite this, there is limited data in the available literature regarding procedures for effective decontamination.