Montagna Maria Teresa, De Giglio Osvalda, Cristina Maria Luisa, Napoli Christian, Pacifico Claudia, Agodi Antonella, Baldovin Tatjana, Casini Beatrice, Coniglio Maria Anna, D'Errico Marcello Mario, Delia Santi Antonino, Deriu Maria Grazia, Guida Marco, Laganà Pasqualina, Liguori Giorgio, Moro Matteo, Mura Ida, Pennino Francesca, Privitera Gaetano, Romano Spica Vincenzo, Sembeni Silvia, Spagnolo Anna Maria, Tardivo Stefano, Torre Ida, Valeriani Federica, Albertini Roberto, Pasquarella Cesira
Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Piazza G. Cesare 11, 70124 Bari, Italy.
Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genova, Italy.
Int J Environ Res Public Health. 2017 Jun 22;14(7):670. doi: 10.3390/ijerph14070670.
Healthcare facilities (HF) represent an at-risk environment for legionellosis transmission occurring after inhalation of contaminated aerosols. In general, the control of water is preferred to that of air because, to date, there are no standardized sampling protocols. air contamination was investigated in the bathrooms of 11 HF by active sampling (Surface Air System and Coriolisμ) and passive sampling using settling plates. During the 8-hour sampling, hot tap water was sampled three times. All air samples were evaluated using culture-based methods, whereas liquid samples collected using the Coriolisμ were also analyzed by real-time PCR. presence in the air and water was then compared by sequence-based typing (SBT) methods. Air contamination was found in four HF (36.4%) by at least one of the culturable methods. The culturable investigation by Coriolisμ did not yield in any enrolled HF. However, molecular investigation using Coriolisμ resulted in eight HF testing positive for in the air. Comparison of air and water contamination indicated that water concentration could be predictive of its presence in the air. Furthermore, a molecular study of 12 strains confirmed a match between the strains from air and water samples by SBT for three out of four HF that tested positive for by at least one of the culturable methods. Overall, our study shows that air detection cannot replace water sampling because the absence of microorganisms from the air does not necessarily represent their absence from water; nevertheless, air sampling may provide useful information for risk assessment. The liquid impingement technique appears to have the greatest capacity for collecting airborne if combined with molecular investigations.
医疗机构（HF）是吸入受污染气溶胶后发生军团菌病传播的高风险环境。一般来说，控制水比控制空气更可取，因为迄今为止，尚无标准化的采样方案。通过主动采样（表面空气系统和Coriolisμ）以及使用沉降板的被动采样，对11家医疗机构的浴室进行了空气污染调查。在8小时采样期间，对热水龙头水进行了三次采样。所有空气样本均采用基于培养的方法进行评估，而使用Coriolisμ收集的液体样本也通过实时PCR进行分析。然后通过基于序列分型（SBT）方法比较空气和水中的[具体内容缺失]存在情况。通过至少一种可培养方法，在四家医疗机构（36.4%）中发现了空气污染。使用Coriolisμ进行的可培养调查在任何登记的医疗机构中均未得出[具体结果缺失]。然而，使用Coriolisμ进行的分子调查导致八家医疗机构的空气中[具体内容缺失]检测呈阳性。空气和水污染的比较表明，[具体内容缺失]的水浓度可以预测其在空气中的存在。此外，对12株[具体内容缺失]菌株的分子研究证实，在通过至少一种可培养方法检测[具体内容缺失]呈阳性的四家医疗机构中，有三家的空气和水样中的[具体内容缺失]菌株通过SBT匹配。总体而言，我们的研究表明，[具体内容缺失]的空气检测不能替代水采样，因为空气中没有微生物不一定意味着水中也没有；尽管如此，空气采样可能为风险评估提供有用信息。如果与分子调查相结合，液体冲击技术似乎具有收集空气中[具体内容缺失]的最大能力。
