Bacterial indoor air contaminations in hospitals in MENA region: a systematic review

Abu-Rub, Lubna I.; Johar, Al-Reem A.; Mana, Hassan Al; Abdelrahman, Hana; Althani, Asmaa; Qotba, Hamda; Yassine, Hadi M.; Eltai, Nahla O.

doi:10.1080/09603123.2022.2083087

Cited by 6 publications

(6 citation statements)

References 65 publications

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“…Every country follows its own standards, if available, applying standards from different settings to healthcare. This not only results in a wide range of different values for acceptable maximum bacterial and fungal loads in healthcare indoor air (13) in different countries, as those values may not be adequate for healthcare purposes, that typically serve an immunocompromised population, different from that present in other settings. In Portugal there are no air quality standards for healthcare, having only one available legislation on this subject, Ordinance n. 353-A/2013 (27), regarding commercial and services buildings.…”

Section: Discussionmentioning

confidence: 99%

“…Great attention is already placed on hand hygiene, respiratory etiquette and disinfection of surfaces (11), but little attention is dedicated to air quality, also considered important for patient and HCW biosafety and health (12). Poor indoor air quality in healthcare settings has already been tied to HAI increase (13) and work-related respiratory diseases (12). Persistence of airborne bacteria in healthcare settings is a proliferating IPC problem that remains relatively understudied (13).…”

Section: Introductionmentioning

confidence: 99%

“…Poor indoor air quality in healthcare settings has already been tied to HAI increase (13) and work-related respiratory diseases (12). Persistence of airborne bacteria in healthcare settings is a proliferating IPC problem that remains relatively understudied (13). Literature is even more scarce regarding AMR features and microbial diversity and distribution in healthcare air (14).…”

Section: Introductionmentioning

confidence: 99%

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Bacterial and fungal load quantitative and qualitative assessment of indoor air in Portuguese long-term and acute healthcare settings

Santos-Marques

Teixeira

Pinheiro

et al. 2023

Preprint

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Background In healthcare-associated infections, the major transmission route is assumed to be the direct or indirect contact between patients, staff, and the environment. However, little is known about the air role as a pool for pathogens and multidrug resistance (MDR) in healthcare settings. The aim of this study was to quantitatively and qualitatively compare microbial air quality in a Portuguese long-term healthcare unit (LTHU) and a central hospital (CH). Methods During 2021 and 2022, air samples were collected fortnightly in both settings and their microbial load (bacteria and fungi) was determined (colony forming units – CFU/m3). Sampled sites were classified according to area, room capacity and occupation, activity and related infection potential risk. Bacterial isolates were randomly selected for identification by Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry, antimicrobial susceptibility testing and polymerase chain reaction (PCR) screening of extended-spectrum beta-lactamases and metallo-beta-lactamases genes. Results A total of 192 air samples were collected, 86 from LTHU and 106 from CH. Statistically significant differences in mean bacterial load in LTHU (367 CFU/m3) and CH (230 CFU/m3) was observed, but not in mean fungal load (LTHU: 87 CFU/m3; CH: 117 CFU/m3). CH bacteria and fungi loads were statistically significantly higher in sites with outpatients or no patients compared to those with inpatients as well as in support services compared to curative care areas. No statistically significant differences were found regarding these variables in LTHU.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bacterial and fungal load quantitative and qualitative assessment of indoor air in Portuguese long-term and acute healthcare settings

Santos-Marques

Teixeira

Pinheiro

et al. 2023

Preprint

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“…However, in the hospital setting, the total bacterial concentration should be less than 100 CFU/m 3 in an area occupied by immunocompromised people [ 12 , 18 ]. A recent systematic review found frequent non-compliance with the WHO recommendation and highlighted the urgent need to define robust strategies and international standards to enhance IAQ in health care facilities [ 19 , 20 ]. Legislation governing IAQ standards has not been developed or implemented in Qatar [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…A recent systematic review found frequent non-compliance with the WHO recommendation and highlighted the urgent need to define robust strategies and international standards to enhance IAQ in health care facilities [ 19 , 20 ]. Legislation governing IAQ standards has not been developed or implemented in Qatar [ 20 ]. Thus, this study aims to assess the levels of airborne bacteria of different Primary Health Care Centers (PHCCs) in the state of Qatar and to compare the concentrations and composition between the hot and cold seasons to provide a baseline upon which an IAQ framework can be built.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Indoor Air Quality of Four Primary Health Care Centers in Qatar

et al. 2022

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Airborne bacteria pose a potential risk to human health upon inhalation in the indoor environments of health care facilities. Airborne bacteria may originate from various sources, including patients, workers, and daily visitors. Hence, this study investigates the quantity, size, and identification of airborne bacteria indoors and outdoors of four Primary Health Care Centers (PHCC) in Doha, Qatar. Air samples were collected from the lobby, triage room, and outside environment of the centers, including, Qatar University (QU-HC), Al-Rayyan (AR-HC), Umm-Ghuwailina (UG-HC), and Old Airport (OA-HC) between August 2020 and March 2021, throughout both the hot and the cold seasons. Samples were collected using an Anderson six-stage cascade impactor. The mean of the total colony-forming units was calculated per cubic meter of air (CFU/m3). QU-HC had the lowest mean of total bacterial count compared with other centers in the indoor and outdoor areas with 100.4 and 99.6 CFU/m3, respectively. In contrast, AR-HC had the highest level, with 459 CFU/m3 indoors, while OA-HC recorded the highest bacterial concentration of the outdoor areas with a total mean 377 CFU/m3. In addition, 16S rRNA sequencing was performed for genera identification. Staphylococcus, Acinetobacter, Bacillus, and Pseudomonas were the four most frequently identified bacterial genera in this study. The abundance of airborne bacteria in the four health centers was higher in the cold season. About 46% of the total airborne bacterial count for three PHCC centers exceeded 300 CFU/m3, making them uncompliant with the World Health Organization’s (WHO) recommendation for indoor settings. Consequently, an IAQ standards should be shaped to establish a baseline for measuring air pollution in Qatar. Additionally, it is crucial to understand seasonal fluctuations better so that hospitals can avoid rising and spreading infection peaks.

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Compendium of analytical methods for sampling, characterization and quantification of bioaerosols

Whitby

Ferguson

Colbeck

et al. 2022

Advances in Ecological Research

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Bacterial indoor air contaminations in hospitals in MENA region: a systematic review

Cited by 6 publications

References 65 publications

Bacterial and fungal load quantitative and qualitative assessment of indoor air in Portuguese long-term and acute healthcare settings

Bacterial and fungal load quantitative and qualitative assessment of indoor air in Portuguese long-term and acute healthcare settings

Assessment of Indoor Air Quality of Four Primary Health Care Centers in Qatar

Compendium of analytical methods for sampling, characterization and quantification of bioaerosols

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