Ijaz M Khalid, Zargar Bahram, Wright Kathryn E, Rubino Joseph R, Sattar Syed A
RB, Montvale, NJ; Department of Biology, Medgar Evers College of the City University of New York (CUNY), Brooklyn, NY.
Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, Canada.
Am J Infect Control. 2016 Sep 2;44(9 Suppl):S109-20. doi: 10.1016/j.ajic.2016.06.008.
Indoor air can be an important vehicle for a variety of human pathogens. This review provides examples of airborne transmission of infectious agents from experimental and field studies and discusses how airborne pathogens can contaminate other parts of the environment to give rise to secondary vehicles leading air-surface-air nexus with possible transmission to susceptible hosts. The following groups of human pathogens are covered because of their known or potential airborne spread: vegetative bacteria (staphylococci and legionellae), fungi (Aspergillus, Penicillium, and Cladosporium spp and Stachybotrys chartarum), enteric viruses (noro- and rotaviruses), respiratory viruses (influenza and coronaviruses), mycobacteria (tuberculous and nontuberculous), and bacterial spore formers (Clostridium difficile and Bacillus anthracis). An overview of methods for experimentally generating and recovering airborne human pathogens is included, along with a discussion of factors that influence microbial survival in indoor air. Available guidelines from the U.S. Environmental Protection Agency and other global regulatory bodies for the study of airborne pathogens are critically reviewed with particular reference to microbial surrogates that are recommended. Recent developments in experimental facilities to contaminate indoor air with microbial aerosols are presented, along with emerging technologies to decontaminate indoor air under field-relevant conditions. Furthermore, the role that air decontamination may play in reducing the contamination of environmental surfaces and its combined impact on interrupting the risk of pathogen spread in both domestic and institutional settings is discussed.
室内空气可能是多种人类病原体的重要传播媒介。本综述提供了来自实验研究和现场研究的病原体空气传播实例，并讨论了空气传播的病原体如何污染环境的其他部分，从而产生二次传播媒介，形成空气-表面-空气联系，并有可能传播给易感宿主。由于已知或潜在的空气传播，以下几类人类病原体被纳入讨论范围：营养细菌（葡萄球菌和军团菌）、真菌（曲霉属、青霉属、枝孢属和炭疽杆菌）、肠道病毒（诺如病毒和轮状病毒）、呼吸道病毒（流感病毒和冠状病毒）、分枝杆菌（结核分枝杆菌和非结核分枝杆菌）以及产芽孢细菌（艰难梭菌和炭疽芽孢杆菌）。本文还概述了实验性生成和回收空气传播的人类病原体的方法，以及对影响室内空气中微生物存活因素的讨论。对美国环境保护局和其他全球监管机构提供的关于空气传播病原体研究的现有指南进行了批判性审查，特别提及了推荐的微生物替代物。介绍了用微生物气溶胶污染室内空气的实验设施的最新进展，以及在实际环境条件下净化室内空气的新兴技术。此外，还讨论了空气净化在减少环境表面污染方面可能发挥的作用，以及其对中断家庭和机构环境中病原体传播风险的综合影响。
