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Abstract：
Introduction The indoor air in hospitals could play a significant role in the transmission of a wide array of infections, especially in respiratory intensive care units, pulmonary outpatient departments, and other areas. Unprotected coughing and sneezing may facilitate the release of aerosols and contaminate the indoor environment. The majority of infections transmitted through these modes include viral diseases, including tuberculosis (TB), influenza, and measles, among several others. Moreover, the possibility of direct and indirect transmission of microbes by air has been underestimated in hospital settings, especially in developing countries. This study therefore was carried out to assess the burden of microbes in the air of selected wards in a tertiary care hospital and evaluate the occupational risk of some infections among healthcare workers (HCWs). Methods This study was carried out between September 2019 and February 2021 at a tertiary care teaching hospital in South India. A total of 30 symptomatic healthcare workers (HCWs) were included in the study and were screened for present and past tuberculosis (TB) as well as other lower respiratory tract infections. A tuberculin skin test, chest X-ray, and sputum acid-fast staining were performed on all the HCWs who were negative for other bacterial infections and were symptomatic. The study was conducted in coordination with the pulmonology department. Active monitoring of air was performed by microbiological air sampler in the respiratory intensive care unit (RICU) and other high-risk areas including the pulmonology outpatient department (OPD), the radiology OPD, and the microbiology department. Results Sputum for tuberculous bacteria was positive in four (16.6%) HCWs. The chest X-ray showed radiological findings suggestive of TB in five (20.8%) HCWs. Three (12.5%) HCWs who were screened for extrapulmonary TB revealed one (33.3%) was positive for TB of the hip joint. Among the HCWs, eight (33%) returned positive tuberculin tests. Assessment of the hospital air in the RICU revealed the bacterial count (288 CFU/m3) exceeded the normal limit (≤50 CFU/m3). The COVID-19 isolation ward showed the lowest bacterial count (06 CFU/m3) and no fungi. The predominant bacterial isolates were gram-positive cocci in clusters (Methicillin-sensitive Staphylococcus aureus). After proper disinfection and correction of ventilation techniques, the resampling results noted microbial colonies under normal limits. Conclusion A high burden of TB was noted among the HCWs. The airborne infection control strategies are essential to minimize the risk of nosocomial infections and occupational TB risk to HCWs. Most microbes are transmitted through the airborne route and therefore it is extremely important to take measures to control the transmission of such pathogens in hospital settings.
摘要：
医院的室内空气可能在广泛感染的传播中起重要作用，尤其是在呼吸重症监护室，肺科门诊,和其他领域。无保护的咳嗽和打喷嚏可能会促进气溶胶的释放并污染室内环境。通过这些模式传播的大多数感染包括病毒性疾病，包括结核病（TB），流感,和麻疹,在其他几个人中。此外，在医院环境中，通过空气直接和间接传播微生物的可能性被低估了，尤其是在发展中国家。因此，进行这项研究是为了评估三级医院选定病房空气中的微生物负担，并评估医护人员（HCW）中某些感染的职业风险。方法本研究于2019年9月至2021年2月在印度南部的三级护理教学医院进行。该研究共纳入了30名有症状的医护人员（HCWs），并筛查了当前和过去的结核病（TB）以及其他下呼吸道感染。结核菌素皮肤试验,胸部X光,对所有其他细菌感染阴性且有症状的HCWs进行痰抗酸染色。该研究是与肺科协调进行的。在呼吸重症监护病房（RICU）和其他包括肺科门诊部（OPD）在内的高风险区域，微生物空气采样器对空气进行了主动监测。放射科OPD,和微生物学系。结果4例(16.6%)HCWs痰中结核菌阳性。胸部X射线检查显示放射学发现，提示有5例（20.8％）HCWs中的TB。3例（12.5％）接受肺外结核筛查的HCWs显示1例（33.3％）髋关节结核呈阳性。在HCW中，8例(33%)结核菌素试验结果为阳性。对RICU医院空气的评估显示细菌计数（288CFU/m3）超过了正常限值（≤50CFU/m3）。COVID-19隔离病房显示细菌计数最低（06CFU/m3），无真菌。主要的细菌分离物是簇状的革兰氏阳性球菌（甲氧西林敏感的金黄色葡萄球菌）。经过适当的消毒和通风技术校正后，重采样结果发现微生物菌落在正常范围内。结论HCWs中结核病负担较高。空气传播感染控制策略对于最大程度地减少医院感染和职业性结核病对HCW的风险至关重要。大多数微生物通过空气传播途径传播，因此采取措施控制此类病原体在医院环境中的传播极为重要。
