Mad-Kow-towing to CJD Risk

Introduction
Creutzfeld-Jakob disease (CJD) is a rare, degenerative, and invariably, fatal
brain disorder. Our organisation reported an incident involving possible
contamination of surgical instruments in its operating theatres. As a
consequence, pathology experienced a considerable increase in cerebrospinal
fluid (CSF) samples requesting Protein 14.3.3 assay and querying CJD.
Method
The existing procedure for handling CSF specimens was to measure protein
and glucose on our mainframe analyser and to process and store samples
through the specimen reception area. Safety concerns initiated a review of
this process. The revised protocol had three key requirements: specimen
handling had to be kept to a minimum, the entire procedure had to be
contained in a biohazard cabinet, and all consumables had to be disposable.
Results
The first requirement was met by transferring responsibility for analysis from the
biochemistry department to microbiology who already handled the specimen
for themselves, cytology and referred the sample for 14.3.3 analysis. We had
to find a compact spectrophotometer which used sealed, single use, disposable
cuvettes and was small enough to be housed inside a biohazard cabinet. The
analyser selected was an Eppendorf EPAC 6140. Considerable input was
required from biochemistry in the early stages of the transition and our staff
were involved in the selection, installation and training. Turn around times
for results have been slightly increased as this is largely a manual procedure.
Conclusion
The processing of all CSF samples has been modified and they are now
received, analysed and stored following this new procedure. It has alleviated
safety concerns in handling potentially ‘infective’ CSF specimens.