Fungal contamination assessment in Portuguese elderly care centers

Assessment of Portuguese fitness centers: Bridging the knowledge gap on harmful microbial contamination with focus on fungi

The lack of knowledge regarding the extent of microbial contamination in Portuguese fitness centers (FC) puts attendees and athletes at risk for bioaerosol exposure. This study intends to characterize microbial contamination in Portuguese FC by passive sampling methods: electrostatic dust collectors (EDC) (N = 39), settled dust (N = 8), vacuum filters (N = 8), and used cleaning mops (N = 12). The obtained extracts were plated in selective culture media for fungi and bacteria. Filters, EDC, and mop samples' extracts were also screened for antifungal resistance and used for the molecular detection of the selected Aspergillus sections. The detection of mycotoxins was conducted using a high-performance liquid chromatograph (HPLC) system and to determine the cytotoxicity of microbial contaminants recovered by passive sampling, HepG2 (human liver carcinoma) and A549 (human alveolar epithelial) cells were employed. The results reinforce the use of passive sampling methods to identify the most critical areas and identify environmental factors that influence microbial contamination, namely having a swimming pool. The cardio fitness area presented the highest median value of total bacteria (TSA: 9.69 × 102 CFU m-2.day-1) and Gram-negative bacteria (VRBA: 1.23 CFU m-2.day-1), while for fungi it was the open space area, with 1.86 × 101 CFU m-2.day-1. Aspergillus sp. was present in EDC and in filters used to collect settled dust. Reduced azole susceptibility was observed in filters and EDC (on ICZ and VCZ), and in mops (on ICZ). Fumonisin B2 was the only mycotoxin detected and it was present in all sampling matrixes except settled dust. High and moderate cytotoxicity was obtained, suggesting that A549 cells were more sensitive to samples' contaminants. The observed widespread of critical toxigenic fungal species with clinical relevance, such as Aspergillus section Fumigati, as well as Fumonisin B2 emphasizes the importance of frequent and effective cleaning procedures while using shared mops appeared as a vehicle of cross-contamination.

Metabarcoding approach to identify bacterial community profiling related to nosocomial infection and bacterial trafficking-routes in hospital environments

Nosocomial infections (NIs) appear in patients under medical care in the hospital. The surveillance of the bacterial communities employing high-resolution 16S rRNA profiling, known as metabarcoding, represents a reliable method to establish factors that may influence the composition of the bacterial population during NIs. The present study aimed to utilize high-resolution 16S rRNA profiling to identify high bacterial diversity by analyzing 11 inside and 10 outside environments from the General Hospital of Ribeirão Preto Medical School, Brazil. Our results identified a high bacterial diversity, and among these, the most abundant bacterial genera linked to NIs were Cutibacterium, Streptococcus, Staphylococcus, and Corynebacterium. A Acinetobacter was detected in cafeterias, bus stops, and adult and pediatric intensive care units (ICUs). Data suggest an association between transport and alimentation areas proximal to the hospital ICU environment. Interestingly, the correlation and clusterization analysis showed the potential of the external areas to directly influence the ICU pediatric department microbial community, including the outpatient's clinic, visitor halls, patient reception, and the closest cafeterias. Our results demonstrate that high-resolution 16S rRNA profiling is a robust and reliable tool for bacterial genomic surveillance. In addition, the metabarcoding approach might help elaborate decontamination policies, and consequently reduce NIs.

Fungal Contamination of Building Materials and the Aerosolization of Particles and Toxins in Indoor Air and Their Associated Risks to Health: A Review

It is now well established that biological pollution is a major cause of the degradation of indoor air quality. It has been shown that microbial communities from the outdoors may significantly impact the communities detected indoors. One can reasonably assume that the fungal contamination of the surfaces of building materials and their release into indoor air may also significantly impact indoor air quality. Fungi are well known as common contaminants of the indoor environment with the ability to grow on many types of building materials and to subsequently release biological particles into the indoor air. The aerosolization of allergenic compounds or mycotoxins borne by fungal particles or vehiculated by dust may have a direct impact on the occupant’s health. However, to date, very few studies have investigated such an impact. The present paper reviewed the available data on indoor fungal contamination in different types of buildings with the aim of highlighting the direct connections between the growth on indoor building materials and the degradation of indoor air quality through the aerosolization of mycotoxins. Some studies showed that average airborne fungal spore concentrations were higher in buildings where mould was a contaminant than in normal buildings and that there was a strong association between fungal contamination and health problems for occupants. In addition, the most frequent fungal species on surfaces are also those most commonly identified in indoor air, regardless the geographical location in Europe or the USA. Some fungal species contaminating the indoors may be dangerous for human health as they produce mycotoxins. These contaminants, when aerosolized with fungal particles, can be inhaled and may endanger human health. However, it appears that more work is needed to characterize the direct impact of surface contamination on the airborne fungal particle concentration. In addition, fungal species growing in buildings and their known mycotoxins are different from those contaminating foods. This is why further in situ studies to identify fungal contaminants at the species level and to quantify their average concentration on both surfaces and in the air are needed to be better predict health risks due to mycotoxin aerosolization.

Effect of fungal indoor air pollutant 1-octen-3-ol on levels of reactive oxygen species and nitric oxide as well as dehydrogenases activities in drosophila melanogaster males

Fungal pollution of indoor environments contributes to several allergic symptoms and represents a public health problem. It is well-established that 1-octen-3-ol, also known as mushroom alcohol, is a fungal volatile organic compound (VOC) commonly found in damp indoor spaces and responsible for the typical musty odor. Previously it was reported that exposure to 1-octen-3-ol induced inflammations and disrupted mitochondrial morphology and bioenergetic rate in Drosophila melanogaster. The aim of this study was to examine the influence of 1-octen-3-ol on dehydrogenase activity, apoptotic biomarkers, levels of nitric oxide (NO) and reactive oxygen species (ROS), as well as antioxidant enzymes activities. D. melanogaster flies were exposed to an atmosphere containing 1-octen-3-ol (2.5 or ∞l/L) for 24 hr. Data demonstrated that 1-octen-3-ol decreased dehydrogenases activity and NO levels but increased ROS levels accompanied by stimulation of glutathione-S-transferase (GST) and superoxide dismutase (SOD) activities without altering caspase 3/7 activation. These findings indicate that adverse mitochondrial activity effects following exposure of D. melanogaster to 1-octen-3-ol, a fungal VOC, may be attributed to oxidant stress. The underlying mechanisms involved in adverse consequences of indoor fungal exposure appear to be related to necrotic but not apoptotic mechanisms. The adverse consequences were sex-dependent with males displaying higher sensitivity to 1-octen-3-ol. Based upon on the fact that the fly genome shares nearly 75% of disease-related genes to human exposure to this fungus may explain the adverse human responses to mold especially for males.

Indoor Air Quality in Elderly Centers: Pollutants Emission and Health Effects

The world population is ageing, in particular in the developed world, with a significant increase in the percentage of people above 60 years old. They represent a segment of the population that is more vulnerable to adverse environmental conditions. Among them, indoor air quality is one of the most relevant, as elders spend comparatively more time indoors than younger generations. Furthermore, the recent COVID-19 pandemic contributed immensely to raising awareness of the importance of breathing air quality for human health and of the fact that indoor air is a vector for airborne infections and poisoning. Hence, this work reviews the state of the art regarding indoor air quality in elderly centers, considering the type of pollutants involved, their emission sources, and their health effects. Moreover, the influence of ventilation on air quality is also addressed. Notwithstanding the potential health problems with the corresponding costs and morbidity effects, only a few studies have considered explicitly indoor air quality and its impacts on elderly health. More studies are, therefore, necessary to objectively identify what are the impacts on the health of elderly people due to the quality of indoor air and how it can be improved, either by reducing the pollutants emission sources or by more adequate ventilation and thermal comfort strategies.

Microbiological analysis of bacterial and fungal bioaerosols from burn hospital of Yazd (Iran) in 2019

INTRODUCTION

Bioaerosols play an important role in incidence of infections in indoor and outdoor air of hospitals. Microorganisms play a critical role in the health of human beings and they are found everywhere in the environment, including different wards of a hospital. So, quantitative and qualitative analysis of microorganisms is highly important in hospital air. The aim of this study was to evaluate the diversity and density of bacteria and fungi in the air of Shohadaye Mehrab Hospital in Yazd City, Iran.

MATERIALS AND METHODS

Sampling was performed using a single-stage pump (Quick Take30) at a flow rate of 28.3 l per minute for five minutes. As a result, 288 indoor and outdoor hospital air samples were collected. Numbers and types of bacterial and fungal colonies were identified using colony morphology, gram staining, and standard microbial tests. Chi-square test, PCA and linear mixed model were run by SPSS version 24.0 for data analysis.

RESULTS

The highest bacterial contaminations were found in the burns ward (294 CFU/m³), operating theater (147 CFU/m³), and emergency department (124 CFU/m³), respectively. Fungal contamination was higher in the derm ward (110 CFU/m³) than other sampling sites. The dominant genus of gram-positive bacteria was Staphylococcus epidermidis (n = 60, 62.5%) and the dominant genus of gram-negative bacteria was Citrobacter freundi (n = 11, 11.5%). The most fungal gens isolated from the hospital air samples were Penicillium (n = 73, 76%), Alternaria (n = 51, 53.1%), Aspergillus niger (n = 40, 41.7%), and Aspergillus flavus (n = 34, 35.4%), respectively.

CONCLUSION

Considering that the burn wounds represent a susceptible site for opportunistic microorganisms, even low concentration of fungi/bacteria in air can be considered as a risk factor that facilitates transmission of the infectious agents in the hospital. Therefore, control measures should be taken to reduce the infection hazard in health staff and patients. These measures include ensuring effective ventilation, cleaning and decontaminating surfaces and equipment, restricting the personnel and patient companions' movement across the wards.

The impact of indoor air quality on respiratory health of older people living in nursing homes: spirometric and exhaled breath condensate assessments

In the Portuguese Geriatric Study of the Health Effects of Indoor Air Quality in Senior Nursing Homes, we aimed to evaluate the impact of indoor air contaminants on the respiratory symptoms and biomarkers in a sample of elderly living in nursing homes. A total of 269 elderly answered a health questionnaire, performed a spirometry and 150 out of these collected an exhaled breath condensate sample for pH and nitrites analysis. The study included the evaluation of indoor chemical and microbiological contaminants. The median age of the participants was 84 (78-87) years and 70.6% were women. The spirometric data indicated the presence of airway obstruction in 14.5% of the sample. Median concentrations of air pollutants did not exceed the existing standards, although increased peak values were observed. In the multivariable analysis, each increment of 100 µg/m³ of total volatile organic compounds was associated with the odds of respiratory infection in the previous three months ( OR̂ =1.05; 95% CI: 1.00-1.09). PM_2.5 concentrations were inversely associated with pH values ( β̂ = -0.04, 95%: -0.06 to -0.01, for each increment of 10 µg/m³). Additionally, a direct and an inverse association were found between total bacteria and FEV₁/FVC and FVC, respectively.

Size-resolved particle oxidative potential in the office, laboratory, and home: Evidence for the importance of water-soluble transition metals

Particulate matter (PM) oxidative potential (OP) is an emerging health metric, but studies examining the OP of indoor PM are rare. This paper focuses on the relationships between respiratory exposure to OP and PM water-soluble composition in indoor environments. Size-resolved PM samples were collected between November 2015 and June 2016 from an office, home (including bedroom, living room, and storeroom), and laboratory using a MOUDI sampler. Particles from each source were segregated into eleven size bins, and the water-soluble metal content and dithiothreitol (DTT) loss rate were measured in each PM extract. The water-soluble OP (OP_ws) of indoor PM was highest in the office and lowest in the home, varying by factors of up to 1.2; these variations were attributed to differences in occupation density, occupant activity, and ventilation. In addition, the particulate Cu, Mn, and Fe concentrations were closely correlated with OP_ws in indoor particles; the transition metals may have acted as catalysts during oxidation processes, inducing ·OH formation through the concomitant consumption of DTT. The OP_ws particle size distributions featured single modes with peaks between 0.18 and 3.2 μm across all indoor sites, reflecting the dominant contribution of PM_3.2 to total PM levels and the enhanced oxidative activity of the PM_3.2 compared to PM_>3.2. Lung-deposition model calculations indicated that PM_3.2 dominated the pulmonary deposition of the OP_ws (>75%) due to both the high levels of metals content and the high deposition efficiency in the alveolar region. Therefore, because OP_ws has been directly linked to various health effects, special attention should be given to PM_3.2.

Internal dose of particles in the elderly-modeling based on aerosol measurements

The paper presents an integrated methodology that combines experimental and modeling techniques and links exposure to airborne particulate matter (PM) with internal dose in the respiratory system and burden in adjacent tissues over a period of time. The methodology is used to estimate doses in the respiratory systems of elders that reside in 10 elderly care centers (ECCs) in the metropolitan area of Lisbon. Measurements of PM were performed in the ECCs and combined with a time-budget survey for the occupants. This information served as input to the first model that estimated particle doses in the different regions of the respiratory tract of the elderly, and then a second model was used to calculate particle build-up in the alveolar region, the interstitium and the hilar lymph nodes of the elders over a 5-year exposure period. It was found that in 5 years of continuous exposure to the average particle concentration measured over all ECCs, 258 mg of all particles are deposited on the surface of the alveoli of which 79.6% are cleared, 18.8% are retained in the alveolar region, 1.5% translocate to the hilar lymph nodes, and 0.1% are transferred to the interstitium.

Fungal burden exposure assessment in podiatry clinics from Ireland

Fungi are amongst the bioaerosols of most importance, as indicated by the growing interest in this field of research. The aim was to characterize the exposure to fungal burden in podiatry clinics using culture-based and molecular methods.

METHODS

Airborne fungi were collected using an impaction air sampler and surface samples were also performed. Fourteen air samples were collected for direct detection of fungal DNA from filamentous fungi and dermatophytes. Overall, 63.6 % of the evening samples and 46 % of the morning samples surpassed the threshold values (150 CFU/m³). Molecular detection, by real time PCR, of the target fungal species/strains (Aspergillus and Stachybotrys species) was negative for all samples collected. Trichophyton rubrum was detected by PCR analysis in one DNA sample collected on day six. Results suggest the use of both culture-based and molecular methodologies are desirable for a complete evaluation of fungal burden in this particular health care setting.

Microbiota and Particulate Matter Assessment in Portuguese Optical Shops Providing Contact Lens Services

The aim of this work was to assess the microbiota (fungi and bacteria) and particulate matter in optical shops, contributing to a specific protocol to ensure a proper assessment. Air samples were collected through an impaction method. Surface and equipment swab samples were also collected side-by-side. Measurements of particulate matter were performed using portable direct-reading equipment. A walkthrough survey and checklist was also applied in each shop. Regarding air sampling, eight of the 13 shops analysed were above the legal requirement and 10 from the 26 surfaces samples were overloaded. In three out of the 13 shops fungal contamination in the analysed equipment was not detected. The bacteria air load was above the threshold in one of the 13 analysed shops. However, bacterial counts were detected in all sampled equipment. Fungi and bacteria air load suggested to be influencing all of the other surface and equipment samples. These results reinforce the need to improve air quality, not only to comply with the legal requirements, but also to ensure proper hygienic conditions. Public health intervention is needed to assure the quality and safety of the rooms and equipment in optical shops that perform health interventions in patients.

Source apportionment of indoor PM10 in Elderly Care Centre

Source contribution to atmospheric particulate matter (PM) has been exhaustively modelled. However, people spend most of their time indoors where this approach is less explored. This evidence worsens considering elders living in Elderly Care Centres, since they are more susceptible. The present study aims to investigate the PM composition and sources influencing elderly exposure. Two 2-week sampling campaigns were conducted-one during early fall (warm phase) and another throughout the winter (cold phase). PM10 were collected with two TCR-Tecora(®) samplers that were located in an Elderly Care Centre living room and in the correspondent outdoor. Chemical analysis of the particles was performed by neutron activation analysis for element characterization, by ion chromatography for the determination of water soluble ions and by a thermal optical technique for the measurement of organic and elemental carbon. Statistical analysis showed that there were no statistical differences between seasons and environments. The sum of the indoor PM10 components measured in this work explained 57 and 53 % of the total PM10 mass measured by gravimetry in warm and cold campaigns, respectively. Outdoor PM10 concentrations were significantly higher during the day than night (p value < 0.05), as well as Ca(2+), Fe, Sb and Zn. The contribution of indoor and outdoor sources was assessed by principal component analysis and showed the importance of the highways and the airport located less than 500 m from the Elderly Care Centre for both indoor and outdoor air quality.

Estimating the inhaled dose of pollutants during indoor physical activity

BACKGROUND

It is undeniable that many benefits come from physical activity. People exercise in fitness centers to improve their health and well-being, prevent disease and to increase physical attractiveness. However, these facilities join conditions that cause poor indoor air quality. Moreover, increased inhalation rates during exercise have influence on inhaled doses of air pollution.

OBJECTIVES

This study aims to calculate the inhaled dose of air pollutants during exercise, by estimating minute ventilation of participants and measuring air pollutant concentrations in fitness centers.

METHODS

Firstly, the 20 participants performed an incremental test on a treadmill, where heart rate and minute ventilation were measured simultaneously to develop individual exponential regression equations. Secondly, heart rate was measured during fitness classes and minute ventilation was estimated based on the calculated regression coefficients. Finally, the inhaled dose of air pollutants was calculated using the estimated minute ventilation and the concentrations of the pollutants measured in a monitoring program performed in 63 fitness classes.

RESULTS

Estimated inhaled doses were higher in aerobic classes than in holistic classes. The main difference was registered for PM10 inhaled dose that presented an average ratio between aerobic and holistic classes greater than four. Minute ventilation and PM10 concentrations in aerobic classes were, on average, 2.0 times higher than in holistic classes. Results showed that inhalation of pollutants is increased during heavy exercise, demonstrating the need to maintain high indoor air quality in fitness centers.

CONCLUSIONS

This study illustrates the importance of inclusion minute ventilation data when comparing inhaled doses of air pollution between different population groups. This work has estimated for the first time the minute ventilation for different fitness classes. Also constitutes an important contribution for the assessment of inhaled dose in future studies to be performed in fitness centers.

Lymphocyte Subsets in a Population of Nonfrail Elderly Individuals

Age-related frailty is characterized by increased vulnerability to stress due to decline in homeostatic reserve, which results in increased risk of adverse health outcomes including disability, hospitalization, and death. The relationship between frailty and immunological system alterations is well established. Thus, analysis of immunological changes, such as alterations in lymphocyte subsets, during senescence may provide useful markers for frailty and associated pathologies. Since reference ranges currently used for lymphocyte subsets do not specifically differentiate the elderly group, the aim of this study was to (1) establish reference ranges in nonfrail elderly individuals and (2) assess the evolution of these parameters with age. Further, the influence of other physiological and lifestyle factors was also evaluated. The study was performed on 144 elderly individuals (aged 65-95) from Galicia (in northwestern Spain). Percentages of lymphocyte subpopulations (CD3(+) T lymphocytes, CD4(+) T-helper lymphocytes, CD8(+) T-cytotoxic lymphocytes, CD19(+) B lymphocytes, and CD56(+)16(+) natural killer cells) were analyzed in peripheral blood by flow cytometry, and reference ranges were calculated. The individual status as nonfrail or prefrail did not markedly affect the immunological parameters, but an apparent influence of age was obtained for %CD3(+), %CD4(+), and %CD19(+) cells, all of which fell with increasing age. Women showed higher levels of %CD19(+) lymphocytes. No significant influence of smoking habits, physical activity, or drinking alcohol or caffeine beverages was observed. The results obtained may serve as a basis to establish comparisons between frail and nonfrail elderly individuals, in order to determine the usefulness of lymphocyte subsets as immunological biomarkers of frailty.

Airborne microorganisms associated with packaging glass sorting facilities

In recent years, efforts have been undertaken to reduce the volume of residual waste through sorting and recycling. The waste management and recycling sector is thriving and the number of workers there is increasing. In this context, prior knowledge of the risks to which workers may be exposed is of crucial importance, and preventive measures need to be put in place to accurately identify and quantify those risks. This study aimed to assess occupational risk of exposure to biological agents (viable bacteria and fungi) in a Portuguese waste packaging glass sorting plant. Air samples were collected from selected locations in waste sorting cabins (critical area, CA), administrative services (noncritical area, NCA) and outdoors (control point, CP). Duplicate air samples were collected through an impaction method. The investigation was carried out over an 8-mo period with two collection periods, autumn/winter (AW) and spring/summer (SS), in order to access the influence of any seasonal variation. In the 36 air samples collected, 319 bacterial and 196 mold identifications were performed. Air samples revealed existence of high environmental contamination by bacteria (1.6 × 10(4) colony forming units [cfu]/m(3)) and fungi (1.5 × 10(4) cfu/m(3)). The predominant bacterial genus was Staphylococcus (coagulase negative) with values ranging from 29.6 to 60% of the total count of bacteria. Genera Bacillus, Micrococcus, and Staphylococcus (coagulase negative) were also present at all sampling sites, regardless of the season. However, the counts of these genera, in the CA, were higher in warmer seasons. The genus Penicillium was the most frequent genus present with an approximate value of 95% of total fungal count in the CA. Seasonal variation was a significant factor for total bacteria and fungi, except for NCA versus CP. Overall, the highest levels of bacterial and fungal species (10(4) cfu/m(3)) were found in the waste sorting cabin (CA). These results highlight the importance of proper design and risk evaluation when planning a new waste facility, such that working conditions minimize proliferation of biological agents in the workplace.