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<p>In developing countries, indoor air quality in neonatal intensive care units (NICUs) remains an overlooked aspect of hospital safety, despite heightened awareness during the COVID-19 pandemic. This study applied a Quantitative Microbial Risk Assessment (QMRA) to evaluate occupational risks posed by airborne, antibiotic-resistant <i>Staphylococcus aureus</i> in a public NICU in Colombia. Mean airborne concentrations of <i>S. aureus</i> were 24.73&#xa0;CFU/m<sup>3</sup>, and particles predominantly ranged from 0.6–7.0&#xa0;µm, suggesting deposition throughout the respiratory tract, including the alveoli.Query Isolated strains exhibited resistance to beta-lactam antibiotics (ampicillin, penicillin G). To characterize uncertainty in risk estimates, a Monte Carlo simulation with 10,000 iterations was performed, with probability distributions assigned to all key input parameters. Annual infection probabilities exceeded the U.S. EPA tolerable risk threshold of 10<sup>−4</sup> across all occupational groups. Median annual risk was highest among male nurses (0.949 pppy; 90% credibility interval: 0.306–1.000), followed by physicians and cleaning staff. Risk varied by gender, age, and job function, with higher estimates observed in men and staff with prolonged exposure times. Sensitivity analysis identified the dose–response parameter k as the dominant source of model uncertainty, followed by airborne concentration. It should be noted that these estimates reflect infection risk in an environment where circulating strains are antibiotic-resistant, rather than the specific probability of developing a resistant infection. These findings highlight the urgent need for bioaerosol-specific occupational health guidelines and improved ventilation control strategies in NICUs, particularly in under-resourced healthcare systems.</p>

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Quantitative microbial risk assessment of antibiotic-resistant Staphylococcus aureus bioaerosol in a neonatal intensive care unit

  • 期刊论文

  • 发表日期：

    2026年7月4日

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  • Dayana Agudelo-Castañeda,
  • Stephanie De la Hoz,
  • Jhorma Medina-Altahona,
  • Gabrielle Pellegrin,
  • Wendy B. Morgado-Gamero

摘要

In developing countries, indoor air quality in neonatal intensive care units (NICUs) remains an overlooked aspect of hospital safety, despite heightened awareness during the COVID-19 pandemic. This study applied a Quantitative Microbial Risk Assessment (QMRA) to evaluate occupational risks posed by airborne, antibiotic-resistant Staphylococcus aureus in a public NICU in Colombia. Mean airborne concentrations of S. aureus were 24.73 CFU/m3, and particles predominantly ranged from 0.6–7.0 µm, suggesting deposition throughout the respiratory tract, including the alveoli.Query Isolated strains exhibited resistance to beta-lactam antibiotics (ampicillin, penicillin G). To characterize uncertainty in risk estimates, a Monte Carlo simulation with 10,000 iterations was performed, with probability distributions assigned to all key input parameters. Annual infection probabilities exceeded the U.S. EPA tolerable risk threshold of 10−4 across all occupational groups. Median annual risk was highest among male nurses (0.949 pppy; 90% credibility interval: 0.306–1.000), followed by physicians and cleaning staff. Risk varied by gender, age, and job function, with higher estimates observed in men and staff with prolonged exposure times. Sensitivity analysis identified the dose–response parameter k as the dominant source of model uncertainty, followed by airborne concentration. It should be noted that these estimates reflect infection risk in an environment where circulating strains are antibiotic-resistant, rather than the specific probability of developing a resistant infection. These findings highlight the urgent need for bioaerosol-specific occupational health guidelines and improved ventilation control strategies in NICUs, particularly in under-resourced healthcare systems.