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Kramer A, Lexow F, Bludau A, Köster AM, Misailovski M, Seifert U, Eggers M, Rutala W, Dancer SJ, Scheithauer S. How long do bacteria, fungi, protozoa, and viruses retain their replication capacity on inanimate surfaces? A systematic review examining environmental resilience versus healthcare-associated infection risk by "fomite-borne risk assessment". Clin Microbiol Rev 2024:e0018623. [PMID: 39388143 DOI: 10.1128/cmr.00186-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2024] Open
Abstract
SUMMARYIn healthcare settings, contaminated surfaces play an important role in the transmission of nosocomial pathogens potentially resulting in healthcare-associated infections (HAI). Pathogens can be transmitted directly from frequent hand-touch surfaces close to patients or indirectly by staff and visitors. HAI risk depends on exposure, extent of contamination, infectious dose (ID), virulence, hygiene practices, and patient vulnerability. This review attempts to close a gap in previous reviews on persistence/tenacity by only including articles (n = 171) providing quantitative data on re-cultivable pathogens from fomites for a better translation into clinical settings. We have therefore introduced the new term "replication capacity" (RC). The RC is affected by the degree of contamination, surface material, temperature, relative humidity, protein load, organic soil, UV-light (sunlight) exposure, and pH value. In general, investigations into surface RC are mainly performed in vitro using reference strains with high inocula. In vitro data from studies on 14 Gram-positive, 26 Gram-negative bacteria, 18 fungi, 4 protozoa, and 37 viruses. It should be regarded as a worst-case scenario indicating the upper bounds of risks when using such data for clinical decision-making. Information on RC after surface contamination could be seen as an opportunity to choose the most appropriate infection prevention and control (IPC) strategies. To help with decision-making, pathogens characterized by an increased nosocomial risk for transmission from inanimate surfaces ("fomite-borne") are presented and discussed in this systematic review. Thus, the review offers a theoretical basis to support local risk assessments and IPC recommendations.
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Affiliation(s)
- Axel Kramer
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Franziska Lexow
- Department for Infectious Diseases, Unit 14: Hospital Hygiene, Infection Prevention and Control, Robert Koch Institute, Berlin, Germany
| | - Anna Bludau
- Department of Infection Control and Infectious Diseases, University Medical Center Göttingen (UMG), Georg-August University Göttingen, Göttingen, Germany
| | - Antonia Milena Köster
- Department of Infection Control and Infectious Diseases, University Medical Center Göttingen (UMG), Georg-August University Göttingen, Göttingen, Germany
| | - Martin Misailovski
- Department of Infection Control and Infectious Diseases, University Medical Center Göttingen (UMG), Georg-August University Göttingen, Göttingen, Germany
- Department of Geriatrics, University of Göttingen Medical Center, Göttingen, Germany
| | - Ulrike Seifert
- Friedrich Loeffler-Institute of Medical Microbiology - Virology, University Medicine Greifswald, Greifswald, Germany
| | - Maren Eggers
- Labor Prof. Dr. G. Enders MVZ GbR, Stuttgart, Germany
| | - William Rutala
- Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Stephanie J Dancer
- Department of Microbiology, University Hospital Hairmyres, Glasgow, United Kingdom
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Simone Scheithauer
- Department of Infection Control and Infectious Diseases, University Medical Center Göttingen (UMG), Georg-August University Göttingen, Göttingen, Germany
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Black WD. A comparison of several media types and basic techniques used to assess outdoor airborne fungi in Melbourne, Australia. PLoS One 2020; 15:e0238901. [PMID: 33338037 PMCID: PMC7748268 DOI: 10.1371/journal.pone.0238901] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 11/25/2020] [Indexed: 11/29/2022] Open
Abstract
Despite the recent increase in interest in indoor air quality regarding mould, there is no universally accepted standard media for the detection of airborne fungi, nor verification of many commonly used techniques. Commonly used media including malt-extract agar (MEA), Sabouraud dextrose agar (Sab), potato dextrose agar (PDA) with and without antibiotics chloramphenicol & gentamycin (CG) were compared for their suitability in detecting a range of airborne fungi by collecting 150 L outdoor air on a number of different days and seasons via an Anderson 400-hole sampler in suburban Melbourne, Australia. There was relatively little variation in mean numbers of colony forming units (CFU) and types of fungi recovered between MEA, PDA, Sab media groups relative to variation within each group. There was a significant difference between Sab, Dichloran-18% glycerol (DG18) and V8® Original juice agar media, however. Antibiotics reliably prevented the growth of bacteria that typically interfered with the growth and appearance of fungal colonies. There was no significant evidence for a growth enhancing factor from potato, mineral supplements or various vegetable juices. Differing glucose concentrations had modest effects, showing a vague ideal at 2%-4% with peptone. Sanitisation of the aluminium Andersen 400-hole sampler top-plate by flame is possible, but not strictly required nor advisable. The use of SabCG as a standard medium was generally supported.
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Affiliation(s)
- Wesley D. Black
- Biotopia Environmental Assessment, Melbourne, Victoria, Australia
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Piñar G, Sclocchi MC, Pinzari F, Colaizzi P, Graf A, Sebastiani ML, Sterflinger K. The Microbiome of Leonardo da Vinci's Drawings: A Bio-Archive of Their History. Front Microbiol 2020; 11:593401. [PMID: 33329475 PMCID: PMC7718017 DOI: 10.3389/fmicb.2020.593401] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/26/2020] [Indexed: 12/04/2022] Open
Abstract
Seven emblematic Leonardo da Vinci’s drawings were investigated through third generation sequencing technology (Nanopore). In addition, SEM analyses were carried out to acquire photographic documentation and to infer the nature of the micro-objects removed from the surface of the drawings. The Nanopore generated microbiomes can be used as a “bio-archive” of the drawings, offering a kind of fingerprint for current and future biological comparisons. This information might help to create a biological catalog of the drawings (cataloging), a microbiome-fingerprint for each single analyzed drawing, as a reference dataset for future studies (monitoring) and last but not least a bio-archive of the history of each single object (added value). Results showed a relatively high contamination with human DNA and a surprising dominance of bacteria over fungi. However, it was possible to identify typical bacteria of the human microbiome, which are mere contaminants introduced by handling of the drawings as well as other microorganisms that seem to have been introduced through vectors, such as insects and their droppings, visible through the SEM analyses. All drawings showed very specific bio-archives, but a core microbiome of bacteria and fungi that are repeatedly found in this type of material as true degraders were identified, such as members of the phyla Proteobacteria, Actinobacteria, and Firmicutes among bacteria, and fungi belonging to the classes Sordariomycetes and Eurotiomycetes. In addition, some similarities were observed that could be influenced by their geographical location (Rome or Turin), indicating the influence of this factor and denoting the importance of environmental and storage conditions on the specific microbiomes.
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Affiliation(s)
- Guadalupe Piñar
- Department of Biotechnology, Institute of Microbiology and Microbial Biotechnology, University of Natural Resources and Life Sciences (BOKU), Vienna, Austria
| | - Maria Carla Sclocchi
- Laboratorio di Biologia, Istituto Centrale per la Patologia degli Archivi e del Libro (ICPAL), Rome, Italy
| | - Flavia Pinzari
- Institute for Biological Systems (ISB), Council of National Research of Italy (CNR), Monterotondo, Italy
| | - Piero Colaizzi
- Laboratorio di Biologia, Istituto Centrale per la Patologia degli Archivi e del Libro (ICPAL), Rome, Italy
| | - Alexandra Graf
- Applied Life Sciences/Bioengineering/Bioinformatics, FH Campus, Vienna, Austria
| | - Maria Letizia Sebastiani
- Laboratorio di Biologia, Istituto Centrale per la Patologia degli Archivi e del Libro (ICPAL), Rome, Italy
| | - Katja Sterflinger
- Department of Biotechnology, Institute of Microbiology and Microbial Biotechnology, University of Natural Resources and Life Sciences (BOKU), Vienna, Austria
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Polyphasic taxonomy of Aspergillus section Aspergillus (formerly Eurotium), and its occurrence in indoor environments and food. Stud Mycol 2017; 88:37-135. [PMID: 28860671 PMCID: PMC5573881 DOI: 10.1016/j.simyco.2017.07.001] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aspergillus section Aspergillus (formerly the genus Eurotium) includes xerophilic species with uniseriate conidiophores, globose to subglobose vesicles, green conidia and yellow, thin walled eurotium-like ascomata with hyaline, lenticular ascospores. In the present study, a polyphasic approach using morphological characters, extrolites, physiological characters and phylogeny was applied to investigate the taxonomy of this section. Over 500 strains from various culture collections and new isolates obtained from indoor environments and a wide range of substrates all over the world were identified using calmodulin gene sequencing. Of these, 163 isolates were subjected to molecular phylogenetic analyses using sequences of ITS rDNA, partial β-tubulin (BenA), calmodulin (CaM) and RNA polymerase II second largest subunit (RPB2) genes. Colony characteristics were documented on eight cultivation media, growth parameters at three incubation temperatures were recorded and micromorphology was examined using light microscopy as well as scanning electron microscopy to illustrate and characterize each species. Many specific extrolites were extracted and identified from cultures, including echinulins, epiheveadrides, auroglaucins and anthraquinone bisanthrons, and to be consistent in strains of nearly all species. Other extrolites are species-specific, and thus valuable for identification. Several extrolites show antioxidant effects, which may be nutritionally beneficial in food and beverages. Important mycotoxins in the strict sense, such as sterigmatocystin, aflatoxins, ochratoxins, citrinin were not detected despite previous reports on their production in this section. Adopting a polyphasic approach, 31 species are recognized, including nine new species. ITS is highly conserved in this section and does not distinguish species. All species can be differentiated using CaM or RPB2 sequences. For BenA, Aspergillus brunneus and A. niveoglaucus share identical sequences. Ascospores and conidia morphology, growth rates at different temperatures are most useful characters for phenotypic species identification.
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Key Words
- A. aurantiacoflavus Hubka, A.J. Chen, Jurjević & Samson
- A. caperatus A.J. Chen, Frisvad & Samson
- A. endophyticus Hubka, A.J. Chen, & Samson
- A. levisporus Hubka, A.J. Chen, Jurjević & Samson
- A. porosus A.J. Chen, Frisvad & Samson
- A. tamarindosoli A.J. Chen, Frisvad & Samson
- A. teporis A.J. Chen, Frisvad & Samson
- A. zutongqii A.J. Chen, Frisvad & Samson
- Ascomycota
- Aspergillaceae
- Aspergillus aerius A.J. Chen, Frisvad & Samson
- Aspergillus proliferans
- Eurotiales
- Eurotium amstelodami
- Extrolites
- Multi-gene phylogeny
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Rintala H, Pitkäranta M, Täubel M. Microbial communities associated with house dust. ADVANCES IN APPLIED MICROBIOLOGY 2016; 78:75-120. [PMID: 22305094 DOI: 10.1016/b978-0-12-394805-2.00004-x] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
House dust is a complex mixture of inorganic and organic material with microbes in abundance. Few microbial species are actually able to grow and proliferate in dust and only if enough moisture is provided. Hence, most of the microbial content originates from sources other than the dust itself. The most important sources of microbes in house dust are outdoor air and other outdoor material tracked into the buildings, occupants of the buildings including pets and microbial growth on moist construction materials. Based on numerous cultivation studies, Penicillium, Aspergillus, Cladosporium, and about 20 other fungal genera are the most commonly isolated genera from house dust. The cultivable bacterial flora is dominated by Gram-positive genera, such as Staplylococcus, Corynebacterium, and Lactococcus. Culture-independent studies have shown that both the fungal and the bacterial flora are far more diverse, with estimates of up to 500-1000 different species being present in house dust. Concentrations of microbes in house dust vary from nondetectable to 10(9) cells g(-1) dust, depending on the dust type, detection method, type of the indoor environment and season, among other factors. Microbial assemblages in different house dust types usually share the same core species; however, alterations in the composition are caused by differing sources of microbes for different dust types. For example, mattress dust is dominated by species originating from the user of the mattress, whereas floor dust reflects rather outdoor sources. Farming homes contain higher microbial load than urban homes and according to a recent study, temperate climate zones show higher dust microbial diversity than tropical zones.
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Affiliation(s)
- Helena Rintala
- Department of Environmental Health, National Institute for Health and Welfare, P.O. Box 95, Kuopio, Finland.
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Borkow G, Assadian O. Survival of Microorganisms on Inanimate Surfaces. USE OF BIOCIDAL SURFACES FOR REDUCTION OF HEALTHCARE ACQUIRED INFECTIONS 2014. [PMCID: PMC7123372 DOI: 10.1007/978-3-319-08057-4_2] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In healthcare settings microbial contaminated surfaces play an important role in indirect transmission of infection. Especially surfaces close to the patients’ environment may be touched at high frequencies, allowing transmission from animated sources to others via contaminated inanimate surfaces. Therefore, the knowledge on the survival of bacteria, fungi, viruses and protozoa on surfaces, and hence, in a broader sense, in the human environment, is important for implementing tactics for prevention of Healthcare-acquired Infections (HAI). This chapter will elaborate the role of surfaces in the transmission of pathogens. Particular emphasis is laid on the current knowledge of the survival time and conditions favouring survival of the pathogens. Finally, mechanisms of transmission from inanimate surfaces to patients are highlighted. Within the multi-barrier strategy of the prevention of HAI, environmental disinfection policies should be based on risk assessments for surfaces with different risks for cross contamination such as high- and low-touched surfaces with appropriate standards for adequate disinfection measures under consideration of the persistence and infectious dose of the pathogens. As a result, surface disinfection is indicated in the following situations:Frequently touched surfaces adjacent to patients Surfaces with assumed or visible contamination Terminal disinfection in rooms or areas where infected or colonized patients with easily transferable nosocomial pathogens are cared for, and in outbreak situations.
Furthermore, the knowledge of the persistence of pathogens will also support ensuring the biosafety in microbiological and biomedical laboratories, food-handling settings, and for hygienic behaviour in the everyday life to prevent transmission of infectious diseases.
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Indoor environment and children's health: recent developments in chemical, biological, physical and social aspects. Int J Hyg Environ Health 2011; 215:1-18. [PMID: 21889403 DOI: 10.1016/j.ijheh.2011.07.008] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2011] [Revised: 07/22/2011] [Accepted: 07/25/2011] [Indexed: 12/11/2022]
Abstract
Much research is being carried out into indoor exposure to harmful agents. This review focused on the impact on children's health, taking a broad approach to the indoor environment and including chemical, microbial, physical and social aspects. Papers published from 2006 onwards were reviewed, with regards to scientific context. Most of publications dealt with chemical exposure. Apart from the ongoing issue of combustion by-products, most of these papers concerned semi volatile organic compounds (such as phthalates). These may be associated with neurotoxic, reprotoxic or respiratory effects and may, therefore, be of particular interest so far as children are concerned. In a lesser extent, volatile organic compounds (such as aldehydes) that have mainly respiratory effects are still studied. Assessing exposure to metals is still of concern, with increasing interest in bioaccessibility. Most of the papers on microbial exposure focused on respiratory tract infections, especially asthma linked to allergens and bio-aerosols. Physical exposure includes noise and electromagnetic fields, and articles dealt with the auditory and non auditory effects of noise. Articles on radiofrequency electromagnetic fields mainly concerned questions about non-thermal effects and papers on extremely low-frequency magnetic fields focused on the characterization of exposure. The impact of the indoor environment on children's health cannot be assessed merely by considering the effect of these different types of exposure: this review highlights new findings and also discusses the interactions between agents in indoor environments and also with social aspects.
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Baudisch C, Assadian O, Kramer A. Evaluation of errors and limits of the 63-microuse-dust-fraction method, a surrogate to predict hidden moisture damage. BMC Res Notes 2009; 2:218. [PMID: 19852825 PMCID: PMC2774334 DOI: 10.1186/1756-0500-2-218] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2009] [Accepted: 10/24/2009] [Indexed: 11/29/2022] Open
Abstract
Background The aim of this study is to analyze possible random and systematic measurement errors and to detect methodological limits of the previously established method. Findings To examine the distribution of random errors (repeatability standard deviation) of the detection procedure, collective samples were taken from two uncontaminated rooms using a sampling vacuum cleaner, and 10 sub-samples each were examined with 3 parallel cultivation plates (DG18). In this two collective samples of new dust, the total counts of Aspergillus spp. varied moderately by 25 and 29% (both 9 cfu per plate). At an average of 28 cfu/plate, the total number varied only by 13%. For the evaluation of the influence of old dust, old and fresh dust samples were examined. In both cases with old dust, the old dust influenced the results indicating false positive results, where hidden moist was indicated but was not present. To quantify the influence of sand and sieving, 13 sites were sampled in parallel using the 63-μm- and total dust collection approaches. Sieving to 63-μm resulted in a more then 10-fold enrichment, due to the different quantity of inert sand in each total dust sample. Conclusion The major errors during the quantitative evaluation from house dust samples for mould fungi as reference values for assessment resulted from missing filtration, contamination with old dust and the massive influence of soil. If the assessment is guided by indicator genera, the percentage standard deviation lies in a moderate range.
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Affiliation(s)
- Christoph Baudisch
- State Health and Social Office of Mecklenburg-Pomerania, Branch Office Schwerin, Germany.
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