Risk factors and mitigation strategies of laboratory-acquired infections in research and clinical laboratories worldwide: a systematic review.

Laboratory-acquired infections and accidental pathogen escapes from laboratory settings pose biosafety risks, affecting laboratory personnel, the scientific community, the general public, animal populations, and the environment. This systematic review compares reports of laboratory-acquired infections and accidental pathogen escapes from laboratory settings in research and clinical laboratories between 2000 and 2024, identifying key risk factors. A total of 250 reports documenting 712 human cases of laboratory-acquired infections were analysed. Research laboratories reported 276 infections and eight fatalities, whereas clinical laboratories accounted for 227 infections and five deaths. Needlestick injuries and ineffective use of personal protective equipment or containment measures were major risk factors in both settings. Research laboratories frequently reported inadequate decontamination techniques, whereas improper sample handling techniques often occurred in clinical laboratories. Given that most causes of laboratory-acquired infections are unknown or under-reported, these data can inform coordinated efforts to strengthen biosafety oversight, incident reporting, and risk management to reduce biosafety lapses and ensure long-term laboratory operations.