Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Family Medicine, Tungs' Taichung Metro Harbor Hospital (TTMHH), Taichung, Taiwan.
Department and Graduate Institute of Public Health, Tzu Chi University, Hualien, Taiwan.
Environ Int. 2020 Nov;144:106024. doi: 10.1016/j.envint.2020.106024. Epub 2020 Aug 11.
Airborne bacteria in hospitals have been implicated in nosocomial infections. This investigation studied the characteristics of airborne bacteria and the effect of patient visitation on the bacteria profile in intensive care units (ICUs). Air at a medical ICU and surgical ICU was sampled for one year. Airborne bacteria before and during visits to patients in ICUs were collected using a Six-Stage Viable Andersen Cascade Impactor to analyze the concentration and size distribution of airborne bacteria and the percentage thereof that were antibiotic-resistant. During patient visitation in the ICUs in this study, the number of visitors was 20-80. Airborne bacteria concentration during visiting hours (total averaging 168.5 CFU/m) was three to four times than before visiting hours (p = 0.043). With increasing the visitors, most of the airborne human-associated bacteria (HAB) concentrations during visitations were higher than before visitations in each season. The two-way ANOVA of HAB concentration before and during visitation (p = 0.028) of combining MICU and SICU in various season (p = 0.007) all revealed statistical agreement. The proportion of particles, from 1.1 to 4.7 µm, during the visits was almost 1-2.4 times that before the visits in most sampling periods (p = 0.028). In addition, the opportunistic pathogens such as Micrococcus spp., Staphylococcus spp. and Acinetobacter spp. were found in the air during visiting times. Small proportions of some environmental strains with a high antibiotic-resistance percentage (42-78%), including Brevundimonas spp., Elizabethkingia spp. and others, were detected during patient visitation. Patient visitation activities affect the bacterial profile in air in ICUs. During the visitation, visitors might bring or generate bacteria into ICUs. Limiting the number of patient visitors to ICUs, wearing respirators and gowns or increasing ventilation rate during and after patient visitation is required to maintain indoor air quality and probably decrease the risk of patient infection.
医院空气中的细菌与医院获得性感染有关。本研究调查了空气中细菌的特征以及患者探视对重症监护病房（ICU）中细菌谱的影响。对一年来医疗 ICU 和外科 ICU 的空气进行了采样。使用六级安德森空气采样器收集 ICU 患者探视前后空气中的细菌，以分析空气中细菌的浓度和大小分布，以及其中抗生素耐药菌的比例。在本研究中 ICU 患者探视期间，访客人数为 20-80 人。探视期间的空气细菌浓度（总平均值为 168.5 CFU/m）是探视前的三到四倍（p=0.043）。随着访客人数的增加，每个季节探视期间大多数与人相关的空气细菌（HAB）浓度都高于探视前。将 MICU 和 SICU 结合起来，在不同季节探视前后 HAB 浓度的双因素方差分析（p=0.028）均显示出统计学上的一致性（p=0.007）。在大多数采样期间，探视期间粒径为 1.1-4.7 µm 的颗粒比例几乎是探视前的 1-2.4 倍（p=0.028）。此外，在探视期间空气中还发现了微球菌属、葡萄球菌属和不动杆菌属等机会性病原体。在探视期间还检测到一些具有高抗生素耐药百分比（42-78%）的环境菌株，包括短小杆菌属、伊丽莎白菌属和其他菌株。患者探视活动会影响 ICU 空气中的细菌谱。在探视期间，访客可能会将细菌带入或带入 ICU。需要限制 ICU 患者访客的数量、在探视期间和之后佩戴口罩和长袍或增加通风率，以维持室内空气质量并可能降低患者感染的风险。
