Particulate matter as a possible reservoir of multidrug-resistant microorganisms in surgical healthcare settings

Aim. To study the microbial diversity and dust organic component in surgical healthcare settings and to assess the risk of dust-mediated transmission of healthcare-associated infections.

Materials and Methods. Dust sampling (n = 41) was carried out using sterile gloves and containers from ventilation grilles and adjacent air ducts of the exhaust ventilation systems in various healthcare settings. Size and shape of dust particles were studied by means of scanning electron microscopy and dynamic light scattering. Elemental analysis (CHNSO) was conducted employing high temperature catalytic oxidation. Bacterial composition of the dust was investigated using a VITEK 2 Compact biochemical analyzer while viral diversity was screened by polymerase chain reaction.

Results. Dust in healthcare units consisted of globular particles and/or microsized fibers. Regardless of the healthcare setting, globular particles prevailed in the dust structure. Dust nanoparticles was characterised by an average first size peak of 85.6 ± 12.6 nm and an average second peak of 307.1 ± 76.2 nm. Dust collected in non-surgical units contained a higher nitrogen content than surgical settings (p < 0.001). Proportions of hydrogen, carbon, and sulfur did not differ between non-surgical and surgical units. The dust collected from healthcare settings in different cities also varied in nitrogen content (p = 0.033). A wide microbial diversity was detected in dust samples and a high frequency (46.34%) of its contamination was found. In surgical departments, dust contamination was notable for multidrug-resistant bacteria (28.57%), while viruses prevailed in non-surgical departments (23.3%).

Conclusions. Dust generated in surgical departments contains nanosized particulate matter, multidrug-resistant microorganisms, and a prominent organic component all defining it as a possible reservoir of multidrug-resistant microorganisms which may potentially cause healthcare-associated infections via airborne transmission.

1. Kalayeva C.Z., Chistyakov Y.V., Muratova K.M., Chebotarev P.V. Influencing fine-dispersed dust upon biosphere and human. Bulletin of Tula State University. Earth Sciences. 2016; 3: 4063 (In Russ.).

2. Mannucci PM, Harari S, Martinelli I, Franchini M. Effects on health of air pollution: a narrative review. Intern Emerg Med. 2015;10(6.):657-662. https://doi.org/10.1007/s11739-015-1276-7

3. Kutikhin A.G., Efimova O.S., Ismagilov Z.R., Barbarash O.L. Air pollution from coal mines and coal chemistry: impact on cardiovascular diseases. Chemistry and Sustainable Development. 2018; 26(6): 647-655. (In Russ.). https://doi.org/10.15372/KhUR20180612.

4. Chezganova E.A., Efimova O.S., Sozinov S.A. et al. Particulate Matter in a Hospital Environment: as Potential Reservoir for Hospital Strains. Epidemiology and Vaccinal Prevention. 2019; 18(4):82-92. (In Russ.). https://doi.org/10.31631/2073-3046-2019-18-4-82-92

5. Baures E, Blanchard O, Mercier Fetal. Indoor air quality in two French hospitals: Measurement of chemical and microbiological contaminants. Sci Total Environ. 2018; 642: 168-179. https://doi.org/10.1016/j.scitotenv.2018.06.047

6. Shestopalov NV, Skopin AYu, Fedorova LS, Gololobova TV. Improving methodological approaches to managing the risk of spreading infections with an aerosol pathogen transmission mechanism. Health Risk Analysis. 2019. (1): 84-92. (In Russ.).

7. Noguchi C, Koseki H, Horiuchi H et al. Factors contributing to airborne particle dispersal in the operating room. BMC Surg. 2017; 17(1):78. https://doi.org/10.1186/s12893-017-0275-1.

8. Akimkin VG, Pokrovsky VI. Nosocomial salmonellosis in adults. Publishing House of Russian Academy of Medical Sciences. 2002; 136 (In Russ.).

9. Kim KH, Kabir E, Kabir S. A review on the human health impact of airborne particulate matter. Environ Int. 2015; 74: 136143. https://doi.org/10.1016/j.envint.2014.10.005

10. Brusina E.B., Kovalishena O.V., Tsigelnik A.M. Healthcare-Associated Infections: Trends and Prevention Prospectives. Epidemiology and Vaccinal Prevention. 2017; 16(4): 73-80. (In Russ.) https://doi.org/10.31631/2073-3046-2017-16-4-73-80

11. Spagnolo AM, Ottria G, Amicizia D el al. Operating theatre quality and prevention of surgical site infections. J Prev Med Hyg. 2013;54(3):131-137

12. Khadartsev A.A., Khrupachev A.G., Kashintseva L.V., Volkov A.V. Risk assessments of ground atmosphere pollution as threats to sustainable development of the territories of industrial nature management. Bulletin of Samara Research Center of the Russian Academy of Sciences. 2016; 2-3 (In Russ.).

13. Solomon FB, Wadilo FW, Arota AA, Abraham YL. Antibiotic resistant airborne bacteria and their multidrug resistance pattern at University teaching referral Hospital in South Ethiopia. Ann Clin Microbiol Antimicrob. 2017; 12; 16(1): 29. https://doi.org/10.1186/s12941-017-0204-2