title: Bioaerosol exposure to personnel in a clinical environment absent patients.
abstract: Nosocomial infections pose a significant and escalating threat to both patients and healthcare workers (HCWs). By their nature, hospitals induce antibiotic resistance in virulent and commensal strains, leading to increasingly severe hospital-acquired infections. This study measured environmental exposure experienced by domestic staff cleaning vacated patient rooms of a community hospital to bacteria in ambient bioaerosols. While they cleaned the room, participants wore an N95 filtering facepiece respirator (FFR), from which coupons were cut and bacteria were extracted, cultured and enumerated. Extrapolation to the full area of the respirator yielded measured exposures of 0.2-1.4 × 10(4) colony-forming units/hour, of which ∼97% collected on the front layer of the N95, suggesting a possible role for minimal respiratory protection in nonpatient environments. Random resistance testing of 1.6% of the isolates showed that ∼70% of both Gram-positive and Gram-negative organisms exhibited resistance to oxacillin and ∼9% of the Gram-positives displayed resistance to vancomycin. These data provide an estimate for mask bioaerosol loading that can be used in risk modeling and to refine strategies for reuse of FFRs during critical shortages.
authors.affiliation: a Applied Research Associates, Engineering Science Division , Panama City , Florida.
authors.forename: Brian K
authors.initials: BK
authors.lastname: Heimbuch
authors.affiliation: a Applied Research Associates, Engineering Science Division , Panama City , Florida.
authors.forename: William H
authors.initials: WH
authors.lastname: Wallace
authors.affiliation: b Universal Technology Corporation, Materials and Manufacturing Division , Dayton , Ohio.
authors.forename: Charles L
authors.initials: CL
authors.lastname: Balzli
authors.affiliation: c Air Force Research Laboratory, Tyndall Air Force Base , Florida.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Laning
authors.affiliation: a Applied Research Associates, Engineering Science Division , Panama City , Florida.
authors.forename: Delbert A
authors.initials: DA
authors.lastname: Harnish
authors.affiliation: d Air Force Civil Engineer Center , Tyndall AFB , Florida.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Wander
mesh_terms: D000391:Air Microbiology; D000395:Air Pollutants, Occupational / Q000032:analysis; D024881:Drug Resistance, Bacterial; D005431:Florida; D006090:Gram-Negative Bacteria / Q000145:classification / Q000302:isolation & purification*; D006094:Gram-Positive Bacteria / Q000145:classification / Q000302:isolation & purification*; D006764:Hospitals, Community; D006797:Housekeeping, Hospital; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control; D016273:Occupational Exposure / Q000032:analysis* / Q000517:prevention & control; D010068:Oxacillin; D012134:Respiratory Protective Devices / Q000382:microbiology; D014640:Vancomycin
chemical_list: D000395:Air Pollutants, Occupational; D014640:Vancomycin; D010068:Oxacillin
keywords: Antibiotic resistance; N95 respirator; background; hospital; infection; nosocomial