Analysis of Microorganisms in Hospital Environments and Potential Risks
This report provides information on indoor air quality and on associated potential risks in hospitals. Spread and persistence of microbial communities in hospital environments are of huge interest to public health. Hospitals are characterized by high infective risk, firstly cause of the compromised immunologic conditions of the patients that make them vulnerable to bacterial, viral, parasitological and fungal opportunistic infections. Evidence suggests that microbial agents spread through air, surfaces, aerosol and hands. If surfaces may act as a reservoir for some pathogens, hands are an important transmission route. Airborne and aerosolized waterborne microorganisms are taken into consideration, and their presence into the hospital environments is reviewed.
KeywordsHospital environment Indoor air quality Infections Microorganisms Pathogens
- Anaissie EJ, Stratton SL, Dignani MC, Lee CK, Summerbell RC, Rex JH, et al. Pathogenic molds (including Aspergillus species) in hospital water distribution systems-a 3-year prospective study and clinical implication for patients with hematologic malignancies. Blood. 2003;101:2542–6. doi: 10.1182/blood-2002-02-0530.CrossRefPubMedGoogle Scholar
- ANSI/ASHRAE Standards. Legionellosis: risk management for building water systems. Atlanta: ANSI; 2015. No. 188.Google Scholar
- ANSI/ASHRAE Standards. Ventilation for acceptable indoor air quality. Atlanta: ANSI; 2016. No. 62.1.Google Scholar
- Bonadonna L, Briancesco R, Coccia AM, Di Napoli I, Ferrante I, Forgia C, et al. Indagini sulla presenza di microrganismi in ambiente ospedaliero e rischi correlati. In: Santarsiero A, Musmeci L, Fuselli S, Gruppo di Studio Nazionale sull’Inquinamento Indoor, ed. Workshop La qualità dell’aria indoor: attuale situazione nazionale e comunitaria. L’esperienza del Gruppo di Studio Nazionale sull’Inquinamento Indoor. Istituto Superiore di Sanità. Roma, 28 maggio 2014. Atti. Roma: Istituto Superiore di Sanità. 2015. Rapporti ISTISAN 15/4:102-8.Google Scholar
- Bottero MC, Buffoli M, Capolongo S, Cavagliato E, di Noia M, Gola M, et al. A multidisciplinary sustainability evaluation system for operative and in-design hospitals. In: Capolongo S, Bottero MC, Buffoli M, Lettieri E, editors. Improving sustainability during hospital design and operation: a multidisciplinary evaluation tool. Cham: Springer; 2015. p. 31–114. doi: 10.1007/978-3-319-14036-0_4.
- Capolongo S, Buffoli M, di Noia M, Gola M, Rostagno M. Current scenario analysis. In: Capolongo S, Bottero MC, Buffoli M, Lettieri E, editors. Improving sustainability during hospital design and operation: a multidisciplinary evaluation tool. Cham: Springer; 2015a. p. 11–22. doi: 10.1007/978-3-319-14036-0_2.
- Capolongo S, Bottero MC, Lettieri E, Buffoli M, Bellagarda A., Birocchi M, et al. Healthcare sustainability challenge. In: Capolongo S, Bottero MC, Buffoli M, Lettieri E, editors. Improving sustainability during hospital design and operation: a multidisciplinary evaluation tool. Cham: Springer; 2015b. 1–10. doi: 10.1007/978-3-319-14036-0_1.
- Caselli E, D’ Accolti M, Vandini A, Lanzoni L, Camerada MT, Coccagna M, et al. Impact of a probiotic-based cleaning intervention on the microbiota ecosystem of the hospital surfaces: focus on the resistome remodulation. PLOS ONE 2016;11(2):1–19. doi: 10.1371/journal.pone.01488572016.
- CDC (Centers for Disease Control). Guidelines for environmental infection control in health-care facilities. Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). Atlanta: U.S. Department of Health and Human Services (HHS) for CDC; 2003. p. 52, No. RR-10.Google Scholar
- D’Alessandro D, Tedesco P, Rebecchi A, Capolongo S. Water use and water saving in Italian hospitals. A preliminary investigation. Ann Ist Super Sanità. 2016;52(1):56–62. doi: 10.4415/ANN_16_01_11.
- Exner M, Kramer A, Lajoie L, Gebel J, Engelhart S, Hartemann P. Prevention and control of health care-associated waterborne infections in health care facilities. Am J Infect Control. 2005;26–39. doi: 10.1016/j.ajic.2005.04.002.
- Joly JR, Alary M. Occurrence of nosocomial Legionnaires’ disease in hospitals with contaminated potable water supply. In: Legionella: current status and emerging perspectives. In: Barbaree JM, Breiman RF, Dufour AP, editors. Washington DC. ASM Press; 1994.Google Scholar
- Mazzacane S, Finzi G, Aparo L, Balboni PG, Vandini A, Antonioli P, et al. The sanification of hospital stays: new strategies for the reduction on HaIs. Health Management 2014. In focus. https://healthmanagement.org/c/healthmanagement/issuearticle/the-sanitation-of-hospital-stays-new-strategies-for-the-reduction-of-hais.
- Smith D, Alverdy J, An G, Coleman M, Garcia-Houchins S, Green J, et al. The hospital microbiome project: meeting report for the 1st hospital microbiome project workshop on sampling design and building science measurements, Chicago, USA, Jun 7th–8th 2012. Stand Genomic Sci. 2013;8:112–7. doi: 10.4056/sigs.3717348.CrossRefPubMedPubMedCentralGoogle Scholar
- Taccone FS, Van den Abeele AM, Bulpa P, Misset B, MeerssemanW Cardoso T, et al. Epidemiology of invasive aspergillosis in critically ill patients: clinical presentation, underlying conditions and outcomes on behalf of the AspICU Study Investigators. Crit Care Med. 2015;19:7. doi: 10.1186/s13054-014-0722-7.Google Scholar
- WHO. Legionella and the prevention of legionellosis. Copenhagen: WHO; 2007.Google Scholar
- WHO. Report on the burden of endemic health care-associated infection worldwide. Copenhagen: WHO; 2011. p. 1–34.Google Scholar