In addition to the hazards described in Chapter 4 for TB laboratories classified as moderate risk, and the general risks that are addressed by the biosafety measures described in Chapter 2, laboratories classified as high-risk (or containment) also face the following challenges, all of which increase risks:
- staff must open positive culture vials;
- staff must prepare smears from positive cultures;
- DNA extraction must be performed on a positive culture;
- manipulation of cultures for identification and indirect DST;
- broken culture containers must be disposed of;
- cultures or areas where spills occurred must be decontaminated.