Chinese expert consensus on biosafety management of highly pathogenic fungi: culture preservation, transport, inactivation, and disposal

Blastomyces dermatitidis, Coccidioides species, Histoplasma species, and Paracoccidioides species are classified as Category II pathogenic microorganisms under China’s Catalogue of Pathogenic Microorganisms Transmissible to Humans. These dimorphic fungi produce aerosolizable spores at ambient temperature, persist in the environment for prolonged periods, and convert in vivo to pathogenic tissue forms, creating specific biosafety risks during culture storage, transport, inactivation, and disposal. Existing national regulations set out broad principles but lack technical specifications tailored to fungal biology. The Fungal Study Group of the Dermatology Branch of the Chinese Medical Association, together with multidisciplinary experts, reviewed Chinese and international regulations, standards, and literature and used a modified Delphi process to establish consensus. Nine recommendations were formulated, covering BSL-3 laboratory prerequisites, culture storage and inventory management, periodic verification and disposal of expired strains, intra- and inter-institutional transport, inactivation and disposal of materials, emergency response to equipment failure, power outage, and culture spills, and post-exposure medical management. This is the first operational technical document in China to address culture preservation, handling, transport, disposal, risk management, and emergency response for highly pathogenic fungal strains, translating statutory requirements into practical, fungus-specific, auditable, verifiable, and traceable procedures for qualified laboratories.