Comparative evaluation of three impactor samplers for measuring airborne bacteria and fungi concentrations

Performance Evaluation and Validation of Air Samplers To Detect Aerosolized Coxiella burnetii

Coxiella burnetii, the etiological agent of Q fever, is an intracellular zoonotic pathogen transmitted via the respiratory route. Once released from infected animals, C. burnetii can travel long distances through air before infecting another host. As such, the ability to detect the presence of C. burnetii in air is important. In this study, three air samplers, AirPort MD8, BioSampler, and the Coriolis Micro, were assessed against a set of predetermined criteria in the presence of three different aerosolized C. burnetii concentrations. Two liquid collection media, phosphate-buffered saline (PBS) and alkaline polyethylene glycol (Alk PEG), were tested with devices requiring a collection liquid. Samples were tested by quantitative polymerase chain reaction assay (qPCR) targeting the single-copy com1 gene or multicopy insertion element IS1111. All air samplers performed well at detecting airborne C. burnetii across the range of concentrations tested. At high nebulized concentrations, AirPort MD8 showed higher, but variable, recovery probabilities. While the BioSampler and Coriolis Micro recovered C. burnetii at lower concentrations, the replicates were far more repeatable. At low and intermediate nebulized concentrations, results were comparable in the trials between air samplers, although the AirPort MD8 had consistently higher recovery probabilities. In this first study validating air samplers for their ability to detect aerosolized C. burnetii, we found that while all samplers performed well, not all samplers were equal. It is important that these results are further validated under field conditions. These findings will further inform efforts to detect airborne C. burnetii around known point sources of infection. IMPORTANCE Coxiella burnetii causes Q fever in humans and coxiellosis in animals. It is important to know if C. burnetii is present in the air around putative sources as it is transmitted via inhalation. This study assessed air samplers (AirPort MD8, BioSampler, and Coriolis Micro) for their efficacy in detecting C. burnetii. Our results show that all three devices could detect aerosolized bacteria effectively; however, at high concentrations the AirPort performed better than the other two devices, showing higher percent recovery. At intermediate and low concentrations AirPort detected at a level higher than or similar to that of other samplers. Quantification of samples was hindered by the limit of quantitation of the qPCR assay. Compared with the other two devices, the AirPort was easier to handle and clean in the field. Testing air around likely sources (e.g., farms, abattoirs, and livestock saleyards) using validated sampling devices will help better estimate the risk of Q fever to nearby communities.

What is the relationship between indoor air quality parameters and airborne microorganisms in hospital environments? A systematic review and meta-analysis

Airborne microorganisms in hospitals have been associated with several hospital-acquired infections (HAIs), and various measures of indoor air quality (IAQ) parameters such as temperature, relative humidity, carbon dioxide (CO₂ ), particle mass concentration, and particle size have been linked to pathogen survival or mitigation of pathogen spread. To investigate whether there are quantitative relationships between the concentration of airborne microorganisms and the IAQ in the hospital environment. Web of Science, Scopus and PubMed databases were searched for studies reporting airborne microbial levels and any IAQ parameter(s) in hospital environments, from database inception to October 2020. Pooled effect estimates were determined via random-effects models. Seventeen of 654 studies were eligible for the meta-analysis. The concentration of airborne microbial measured as aerobic colony count (ACC) was significantly correlated with temperature (r = 0.25 [95% CI = 0.06-0.42], p = 0.01), CO₂ concentration (r = 0.53 [95% CI = 0.40-0.64], p ˂ 0.001), particle mass concentration (≤5 µg/m³ ; r = 0.40 [95% CI = 0.04-0.66], p = 0.03), and particle size (≤5 and ˃5 µm), (r = 0.51 [95% CI = 0.12-0.77], p = 0.01 and r = 0.55 [95% CI = 0.20-0.78], p = 0.003), respectively, while not being significantly correlated with relative humidity or particulate matter of size >5 µm. Conversely, airborne total fungi (TF) were not significantly correlated with temperature, relative humidity, or CO₂ level. However, there was a significant weak correlation between ACC and TF (r = 0.31 [95% CI = 0.07-0.52], p = 0.013). Although significant correlations exist between ACC and IAQ parameters, the relationship is not definitive; the IAQ parameters may affect the microorganisms but are not responsible for the presence of airborne microorganisms. Environmental parameters could be related to the generating source, survival, dispersion, and deposition rate of microorganisms. Future studies should record IAQ parameters and factors such as healthcare worker presence and the activities carried out such as cleaning, sanitizing, and disinfection protocols. Foot traffic would influence both the generation of microorganisms and their deposition rate onto surfaces in the hospital environment. These data would inform models to improve the understanding of the likely concentration of airborne microorganisms and provide an alternative approach for real-time monitoring of the healthcare environment.

Monitoring of clinical strains and environmental fungal aerocontamination to prevent invasive aspergillosis infections in hospital during large deconstruction work: a protocol study

INTRODUCTION

Monitoring fungal aerocontamination is an essential measure to prevent severe invasive aspergillosis (IA) infections in hospitals. One central block among 32 blocks of Edouard Herriot Hospital (EHH) was entirely demolished in 2015, while care activities continued in surrounding blocks. The main objective was to undertake broad environmental monitoring and clinical surveillance of IA cases to document fungal dispersion during major deconstruction work and to assess clinical risk.

METHODS AND ANALYSIS

A daily environmental survey of fungal loads was conducted in eight wards located near the demolition site. Air was collected inside and outside selected wards by agar impact samplers. Daily spore concentrations were monitored continuously by volumetric samplers at a flow rate of 10 L.min^-1. Daily temperature, wind direction and speed as well as relative humidity were recorded by the French meteorological station Meteociel. Aspergillus fumigatus strains stored will be genotyped by multiple-locus, variable-number, tandem-repeat analysis. Antifungal susceptibility will be assessed by E-test strips on Roswell Park Memorial Institute medium supplemented with agar. Ascertaining the adequacy of current environmental monitoring techniques in hospital is of growing importance, considering the rising impact of fungal infections and of curative antifungal costs. The present study could improve the daily management of IA risk during major deconstruction work and generate new data to ameliorate and redefine current guidelines.

ETHICS AND DISSEMINATION

This study was approved by the clinical research and ethics committees of EHH.