title: Microorganisms in Confined Habitats: Microbial Monitoring and Control of Intensive Care Units, Operating Rooms, Cleanrooms and the International Space Station.
abstract: Indoor environments, where people spend most of their time, are characterized by a specific microbial community, the indoor microbiome. Most indoor environments are connected to the natural environment by high ventilation, but some habitats are more confined: intensive care units, operating rooms, cleanrooms and the international space station (ISS) are extraordinary living and working areas for humans, with a limited exchange with the environment. The purposes for confinement are different: a patient has to be protected from infections (intensive care unit, operating room), product quality has to be assured (cleanrooms), or confinement is necessary due to extreme, health-threatening outer conditions, as on the ISS. The ISS represents the most secluded man-made habitat, constantly inhabited by humans since November 2000 - and, inevitably, also by microorganisms. All of these man-made confined habitats need to be microbiologically monitored and controlled, by e.g., microbial cleaning and disinfection. However, these measures apply constant selective pressures, which support microbes with resistance capacities against antibiotics or chemical and physical stresses and thus facilitate the rise of survival specialists and multi-resistant strains. In this article, we summarize the available data on the microbiome of aforementioned confined habitats. By comparing the different operating, maintenance and monitoring procedures as well as microbial communities therein, we emphasize the importance to properly understand the effects of confinement on the microbial diversity, the possible risks represented by some of these microorganisms and by the evolution of (antibiotic) resistances in such environments - and the need to reassess the current hygiene standards.
authors: Department for Internal Medicine, Medical University of Graz, Graz Austria.
authors: Maximilian
authors: M
authors: Mora
authors: Institute of Environmental Biotechnology, Graz University of Technology, Graz Austria.
authors: Alexander
authors: A
authors: Mahnert
authors: Department for Internal Medicine, Medical University of Graz, GrazAustria; BioTechMed-Graz, GrazAustria.
authors: Kaisa
authors: K
authors: Koskinen
authors: Department for Internal Medicine, Medical University of Graz, Graz Austria.
authors: Manuela R
authors: MR
authors: Pausan
authors: Department of Pathology, Medical University of Graz, Graz Austria.
authors: Lisa
authors: L
authors: Oberauner-Wappis
authors: Department for Internal Medicine, Medical University of Graz, Graz Austria.
authors: Robert
authors: R
authors: Krause
authors: Department for Internal Medicine, Medical University of Graz, GrazAustria; Department for Microbiology, University of Regensburg, RegensburgGermany.
authors: Alexandra K
authors: AK
authors: Perras
authors: BioTechMed-Graz, GrazAustria; Department of Pathology, Medical University of Graz, GrazAustria.
authors: Gregor
authors: G
authors: Gorkiewicz
authors: Institute of Environmental Biotechnology, Graz University of Technology, Graz Austria.
authors: Gabriele
authors: G
authors: Berg
authors: Department for Internal Medicine, Medical University of Graz, GrazAustria; BioTechMed-Graz, GrazAustria.
authors: Christine
authors: C
authors: Moissl-Eichinger
keywords: built environment; confined habitat; indoor; microbiome; microorganisms