Antibiotic resistance of airborne viable bacteria and size distribution in neonatal intensive care units
Despite their significant impact on public health, antibiotic resistance and size distributions of airborne viable bacteria in indoor environments in neonatal intensive care units (NICU) remain understudied. Therefore, the objective of this study was to assess the antibiotic resistance of airborne v...
- Autores:
-
MORGADO GAMERO, WENDY BEATRIZ
Mendoza Hernandez, Martha
Castillo Ramirez, Margarita
MEDINA ALTAHONA, JHORMA JOSE
La Hoz Theuer, Stephanie
Posso Mendoza, Heidy
Parody, Alexander
Teixeira, Elba C.
Agudelo-Castañeda, Dayana Milena
- Tipo de recurso:
- Article of journal
- Fecha de publicación:
- 2019
- Institución:
- Corporación Universidad de la Costa
- Repositorio:
- REDICUC - Repositorio CUC
- Idioma:
- eng
- OAI Identifier:
- oai:repositorio.cuc.edu.co:11323/5393
- Acceso en línea:
- https://hdl.handle.net/11323/5393
https://repositorio.cuc.edu.co/
- Palabra clave:
- Bioaerosols
Neonatal intensive care unit
Antibiotic resistance
Public health
- Rights
- openAccess
- License
- CC0 1.0 Universal
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RCUC2_958a365b4d02c329dfc6587137a2aaa7 |
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oai:repositorio.cuc.edu.co:11323/5393 |
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REDICUC - Repositorio CUC |
repository_id_str |
|
dc.title.spa.fl_str_mv |
Antibiotic resistance of airborne viable bacteria and size distribution in neonatal intensive care units |
title |
Antibiotic resistance of airborne viable bacteria and size distribution in neonatal intensive care units |
spellingShingle |
Antibiotic resistance of airborne viable bacteria and size distribution in neonatal intensive care units Bioaerosols Neonatal intensive care unit Antibiotic resistance Public health |
title_short |
Antibiotic resistance of airborne viable bacteria and size distribution in neonatal intensive care units |
title_full |
Antibiotic resistance of airborne viable bacteria and size distribution in neonatal intensive care units |
title_fullStr |
Antibiotic resistance of airborne viable bacteria and size distribution in neonatal intensive care units |
title_full_unstemmed |
Antibiotic resistance of airborne viable bacteria and size distribution in neonatal intensive care units |
title_sort |
Antibiotic resistance of airborne viable bacteria and size distribution in neonatal intensive care units |
dc.creator.fl_str_mv |
MORGADO GAMERO, WENDY BEATRIZ Mendoza Hernandez, Martha Castillo Ramirez, Margarita MEDINA ALTAHONA, JHORMA JOSE La Hoz Theuer, Stephanie Posso Mendoza, Heidy Parody, Alexander Teixeira, Elba C. Agudelo-Castañeda, Dayana Milena |
dc.contributor.author.spa.fl_str_mv |
MORGADO GAMERO, WENDY BEATRIZ Mendoza Hernandez, Martha Castillo Ramirez, Margarita MEDINA ALTAHONA, JHORMA JOSE La Hoz Theuer, Stephanie Posso Mendoza, Heidy Parody, Alexander Teixeira, Elba C. Agudelo-Castañeda, Dayana Milena |
dc.subject.spa.fl_str_mv |
Bioaerosols Neonatal intensive care unit Antibiotic resistance Public health |
topic |
Bioaerosols Neonatal intensive care unit Antibiotic resistance Public health |
description |
Despite their significant impact on public health, antibiotic resistance and size distributions of airborne viable bacteria in indoor environments in neonatal intensive care units (NICU) remain understudied. Therefore, the objective of this study was to assess the antibiotic resistance of airborne viable bacteria for different sizes (0.65–7 µm) in private-style and public-style neonatal intensive care units (NICU). Airborne bacteria concentrations were assessed by a six-stage Andersen impactor, operating at 28.3 L/min. Public-style NICU revealed higher concentrations of airborne viable bacteria (53.00 to 214.37 CFU/m3) than private-style NICU (151.94–466.43), indicating a possible threat to health. In the public-style NICU, Staphylococcus was the highest bacterial genera identified in the present study, were Staphylococcus saprophyticus and Staphylococcus epidermidis predominated, especially in the second bronchi and alveoli size ranges. Alloiococcus otitidis, Bacillus subtiles, Bacillus thuringiensis, Kocuria rosea, and Pseudomonas pseudoalcaligene, were identified in the alveoli size range. In NICU#2, eight species were identified in the alveoli size range: Bacillus cereus, Bacillus subtilis, Bacillus thuringiensis, Eikenella corrodens, Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus gordoni. Multi-drug-resistant organisms (MDROs) were found in both of the NICUs. Bacillus cereus strains were resistant to Ampicillin, Cefoxitin, Ceftaroline, and Penicillin G. Staphylococcus cohnii ssp. cohnii was resistant in parallel to ampicillin and G penicillin. Staphylococcus saprophyticus strains were resistant to Ampicillin, Penicillin G, Oxaxilin, and Erythromycin. Results may indicate a potential threat to human health due to the airborne bacteria concentration and their antibiotic resistance ability. The results may provide evidence for the need of interventions to reduce indoor airborne particle concentrations and their transfer to premature infants with underdeveloped immune systems, even though protocols for visitors and cleaning are well-established. |
publishDate |
2019 |
dc.date.accessioned.none.fl_str_mv |
2019-10-02T15:29:12Z |
dc.date.available.none.fl_str_mv |
2019-10-02T15:29:12Z |
dc.date.issued.none.fl_str_mv |
2019-09-10 |
dc.type.spa.fl_str_mv |
Artículo de revista |
dc.type.coar.fl_str_mv |
http://purl.org/coar/resource_type/c_2df8fbb1 |
dc.type.coar.spa.fl_str_mv |
http://purl.org/coar/resource_type/c_6501 |
dc.type.content.spa.fl_str_mv |
Text |
dc.type.driver.spa.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.redcol.spa.fl_str_mv |
http://purl.org/redcol/resource_type/ART |
dc.type.version.spa.fl_str_mv |
info:eu-repo/semantics/acceptedVersion |
format |
http://purl.org/coar/resource_type/c_6501 |
status_str |
acceptedVersion |
dc.identifier.issn.spa.fl_str_mv |
1661-7827 1660-4601 |
dc.identifier.uri.spa.fl_str_mv |
https://hdl.handle.net/11323/5393 |
dc.identifier.instname.spa.fl_str_mv |
Corporación Universidad de la Costa |
dc.identifier.reponame.spa.fl_str_mv |
REDICUC - Repositorio CUC |
dc.identifier.repourl.spa.fl_str_mv |
https://repositorio.cuc.edu.co/ |
identifier_str_mv |
1661-7827 1660-4601 Corporación Universidad de la Costa REDICUC - Repositorio CUC |
url |
https://hdl.handle.net/11323/5393 https://repositorio.cuc.edu.co/ |
dc.language.iso.none.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.spa.fl_str_mv |
https://doi.org/10.3390/ijerph16183340 |
dc.relation.references.spa.fl_str_mv |
1. Gao, M.; Yan, X.; Qiu, T.; Han, M.; Wang, X. Variation of correlations between factors and culturable airborne bacteria and fungi. Atmos. Environ. 2016, 128, 10–19. [CrossRef] 2. Jara Hernández, E.L.; Piraquive Mórtola, J.S. Determinación de la Calidad de Aire Intrmural en la Clínica Veterinaria, Universidad de la Salle; Universidad de la Salle: Bogotá, Colombia, 2016. 3. Kim, K.H.; Kabir, E.; Jahan, S.A. Airborne bioaerosols and their impact on human health. J. Environ. Sci. (China) 2018, 67, 23–35. [CrossRef] [PubMed] 4. Yao, M.; Colbeck, I.; Lazaridis, M.; Liu, K.F.; Hung, M.; Shen, Y.; Reijula, K.; Tringe, S.G.; Zhang, T.; Liu, X.; et al. Bioaerosol: A bridge and opportunity for many scientific research fields. J. Aerosol Sci. 2018, 115, 108–112. [CrossRef] 5. Smets, W.; Moretti, S.; Denys, S.; Lebeer, S. Airborne bacteria in the atmosphere: Presence, purpose, and potential. Atmos. Environ. 2016, 139, 214–221. [CrossRef] 6. Fröhlich-Nowoisky, J.; Kampf, C.J.; Weber, B.; Huffman, J.A.; Pöhlker, C.; Andreae, M.O.; Lang-Yona, N.; Burrows, S.M.; Gunthe, S.S.; Elbert, W.; et al. Bioaerosols in the Earth system: Climate, health, and ecosystem interactions. Atmos. Res. 2016, 182, 346–376. [CrossRef] 7. Walser, S.M.; Gerstner, D.G.; Brenner, B.; Bünger, J.; Eikmann, T.; Janssen, B.; Kolb, S.; Kolk, A.; Nowak, D.; Raulf, M.; et al. Evaluation of exposure-response relationships for health effects of microbial bioaerosols - A systematic review. Int. J. Hyg. Environ. Health 2015, 218, 577–589. [CrossRef] 8. Edith, G.; Espinoza, C. Determinación de Organismos Mesófilos Aerobios en el Ambiente de Cd. Obregón, Sonora; Mediante el uso del Monitor aéreo Microbiológico y Método de Cuenta en Placa Abierta. Available online: https://docplayer.es/42154583-Tesis-que-para-obtener-el-titulo-de-ingeniero-biotecnologo-presentagloria-edith-camacho-espinoza.html (accessed on 17 May 2019). 9. Pelczar, M.J.; Chan, E.C.S.; Krieg, N.R. Microbiology, 5th ed.; Tata Mc Graw Hill: New York, NY, USA, 1993. 10. Cabo Verde, S.; Almeida, S.M.; Matos, J.; Guerreiro, D.; Meneses, M.; Faria, T.; Botelho, D.; Santos, M.; Viegas, C. Microbiological assessment of indoor air quality at different hospital sites. Res. Microbiol. 2015, 166, 557–563. [CrossRef] 11. Abdel-Wahab, F.; Ghoneim, M.; Khashaba, M.; El-Gilany, A.-H.; Abdel-Hady, D. Nosocomial infection surveillance in an Egyptian neonatal intensive care unit. J. Hosp. Infect. 2013, 83, 196–199. [CrossRef] 12. Youn, K.; Shin, Y. Daekeun Distribution characteristics of airborne bacteria and fungi in the general hospitals of Korea. Ind. Health 2010, 48, 236–243. 13. Jaffal, A.A.; Nsanze, H.; Bener, A.; Ameen, A.S.; Banat, I.M.; Mogheth, A.A. El Hospital airborne microbial pollution in a desert country. Environ. Int. 1997, 23, 167–172. [CrossRef] 14. Hernandez, M.; León, S. Determinación de la Calidad del Aire Extramural E Intramural en la Sala de Cirugía del Hospital el Tunal de la Cuidad De Bogotá Para el Desarrollo de Mecanismos de Control y Minimización De Riesgo Causado por Microorganismos Potencialmente Nosocomiales. Available online: http://repository. lasalle.edu.co/bitstream/handle/10185/14040/T41.08%20H43d.pdf?sequence=1&isAllowed=y (accessed on 17 May 2019). 15. Leung, M.; Chan, A.H.S. Control and management of hospital indoor air quality. Med. Sci. Monit. 2006, 12, SR17–SR23. 16. Coronell, W.; Rojas, J.; Escamilla, M.; Manotas, M.; Sánchez, M. Infección Nosocomial En Unidades de Cuidados Intensivos Neonatales. Precop. Scp. 2010, 9, 30–39. 17. Morgado Gamero, W.B.; Ramírez, M.C.; Parody, A.; Viloria, A.; López, M.H.A.; Kamatkar, S.J. Concentrations and Size Distributions of Fungal Bioaerosols in a Municipal Landfill. In Data Mining and Big Data; Tan, Y., Shi, Y., Tang, Q., Eds.; Springer International Publishing: Cham, Switzerland, 2018; pp. 244–253. 18. Zhu, H.; Phelan, P.; Duan, T.; Raupp, G.; Fernando, H.J.S. Characterizations and relationships between outdoor and indoor bioaerosols in an office building. China Particuology 2003, 1, 119–123. [CrossRef] 19. Wang, W.; Ma, Y.; Ma, X.; Wu, F.; Ma, X.; An, L.; Feng, H. Diversity and seasonal dynamics of airborne bacteria in the Mogao Grottoes, Dunhuang, China. Aerobiologia 2012, 28, 27–38. [CrossRef] 20. Claudia Andrea, C.T. Evaluación del Comportamiento de Aerobacterias en el Corregimiento de Cuatro Bocas. Tubará, Atlántico. Available online: https://www.researchgate.net/profile/Wendy_Morgado_ Gamero/publication/325478384_EVALUATION_OF_THE_BEHAVIOR_OF_AIRBORNE_BACTERIA_ IN_THE_VILLAGE_OF_CUATRO_BOCAS_TUBARA_ATLANTICO/links/5b106cdea6fdcc4611d977e4/ EVALUATION-OF-THE-BEHAVIOR-OF-AIRBORNE-BACTERIA-IN-THE-VILLAGE-OF-CUATROBOCAS-TUBARA-ATLANTICO.pdf?origin=publication_detail (accessed on 17 May 2019). 21. Ortiz, J.; Préndez Bolívar, M.M.; Solezzi, S. Utilizacion y manejo de un impactador de cascada ANDERSEN en el estudio de los aerosoles atmosfericos. Medio Ambiente 1986, 8, 3–8. 22. Heo, Y.; Park, J.; Lim, S.; Hur, H.; Kim, D.; Park, K. Size-resolved culturable airborne bacteria sampled in rice field, sanitary landfill, and waste incineration sites. J. Environ. Monit. 2010, 12, 1619. [CrossRef] [PubMed] 23. Li, C.S.; Hou, P.A. Bioaerosol characteristics in hospital clean rooms. Sci. Total Environ. 2003, 305, 169–176. [CrossRef] 24. Morgado Gamero, W.B.; Agudelo-Castañeda, D.; Ramirez, M.C.; Hernandez, M.M.; Mendoza, H.P.; Parody, A.; Viloria, A. Hospital Admission and Risk Assessment Associated to Exposure of Fungal Bioaerosols at a Municipal Landfill Using Statistical Models. In Intelligent Data Engineering and Automated Learning—IDEAL 2018; Yin, H., Camacho, D., Novais, P., Tallón-Ballesteros, A.J., Eds.; Springer International Publishing: Cham, Switzerland, 2018; pp. 210–218. 25. Ghosh, B.; Lal, H.; Srivastava, A. Review of bioaerosols in indoor environment with special reference to sampling, analysis and control mechanisms. Environ. Int. 2015, 85, 254–272. [CrossRef] 26. Kim, K.Y.; Kim, C.N. Airborne microbiological characteristics in public buildings of Korea. Build. Environ. 2007, 42, 2188–2196. [CrossRef] 27. Awad, A.H.; Saeed, Y.; Hassan, Y.; Fawzy, Y.; Osman, M. Air microbial quality in certain public buildings, Egypt: A comparative study. Atmos. Pollut. Res. 2018, 9, 617–626. [CrossRef] 28. He, C.; Mackay, I.M.; Ramsay, K.; Liang, Z.; Kidd, T.; Knibbs, L.D.; Johnson, G.; McNeale, D.; Stockwell, R.; Coulthard, M.G.; et al. Particle and bioaerosol characteristics in a paediatric intensive care unit. Environ. Int. 2017, 107, 89–99. [CrossRef] [PubMed] 29. Licina, D.; Bhangar, S.; Brooks, B.; Baker, R.; Firek, B.; Tang, X.; Morowitz, M.J.; Banfield, J.F.; Nazaroff, W.W. Concentrations and sources of airborne particles in a neonatal intensive care unit. PLoS ONE 2016, 11, e0154991. [CrossRef] [PubMed] 30. Berenguer, J.; Sanz, J.L. Cuestiones en Microbiología; Editorial Hélice: Madrid, Spain, 2004. 31. Maldonado-Vega, M.; Peña-Cabriales, J.J.; De los Santos, S.; Castellanos-Arévalo, A.P.; Camarena-Pozos, D.; Arévalo-Rivas, B.; Valdés-Santiago, L.; Hernández-Valadez, L.J.; Guzmán De Peña, D.L. Bioaerosoles y evaluación de la calidad del aire en dos centros hospitalarios ubicados en León, Guanaguato, México (Bioaerosols and air quality assessment in two hospitals located in León, Guanajuato, Mexico). Rev. Int. Contam. Ambient 2014, 30, 351–363. 32. SAMPSP (Sociedad Andaluza de Medicina Preventiva y Salud Pública). Recomendaciones Para la Monitorización de la Calidad Microbiológica del Aire (Bioseguridad Ambiental) en Zonas Hospitalarias de Riesgo; SAMPSP: Andalucía, Spain, 2016; pp. 1–35. 33. Colombia. Ministerio de Salud y Protección Social Resolución 002003 de 2014. Available online: https: //www.minsalud.gov.co/Normatividad_Nuevo/Resoluci%C3%B3n%202003%20de%202014.pdf (accessed on 17 May 2019). 34. Macher, J.M.; Chatigny, M.A.; Burge, H.A. Sampling Airborne Microorganisms and Aeroallergens. In Air Sampling Instruments for Evaluation of Atmospheric Contaminan; ACGIH: Cincinnati, OH, USA, 1995; pp. 589–617. 35. Rao, C.Y.; Burge, H.A.; Chang, J.C. Review of quantitative standards and guidelines for fungi in indoor air. J. Air Waste Manag. Assoc. 1996, 46, 899–908. [CrossRef] 36. IAQA (Indoor Air Quality Association). Indoor Air Quality Standard #95-1 Recommended for Florida; IAQA: Longwood, FL, USA, 1995. 37. Heida, H.; Bartman, F.; van der Zee, S.C. Occupational Exposure and Indoor Air Quality Monitoring in a Composting Facility. Am. Ind. Hyg. Assoc. J. 1995, 56, 39–43. [CrossRef] 38. OSHA (Occupational Safety and Health Administration). Indoor Air Quality; OSHA: Washington, DC, USA, 1994; pp. 15968–16039. 39. Aryanna Kelly Pinheiro, S. Microbiota Fúngica do Ambiente da uti Neonatal e de Amostras Clínicas dos Recém-Nascidos Internados no Hospital Universitário de Maceió. Master’s Thesis, Universidade Federal de Alagoas, Maceio, Brazil, 2009. 40. Viegas, C.; Faria, T.; dos Santos, M.; Carolino, E.; Gomes, A.Q.; Sabino, R.; Viegas, S. Fungal burden in waste industry: An occupational risk to be solved. Environ. Monit. Assess. 2015, 187, 199. [CrossRef] 41. Yamamoto, N.; Schmechel, D.; Chen, B.T.; Lindsley, W.G.; Peccia, J. Comparison of quantitative airborne fungi measurements by active and passive sampling methods. J. Aerosol Sci. 2011, 42, 499–507. [CrossRef] 42. Sady´s, M.; Kennedy, R.; West, J.S. Potential impact of climate change on fungal distributions: Analysis of 2 years of contrasting weather in the UK. Aerobiologia 2016, 32, 127–137. [CrossRef] 43. Dungan, R.S. Board-invited review: Fate and transport of bioaerosols associated with livestock operations and manures. J. Anim. Sci. 2010, 88, 3693–3706. [CrossRef] 44. Pahari, A.K.; Dasgupta, D.; Patil, R.S.; Mukherji, S. Emission of bacterial bioaerosols from a composting facility in Maharashtra, India. Waste Manag. 2016, 53, 22–31. [CrossRef] 45. Adams, R.I.; Miletto, M.; Lindow, S.E.; Taylor, J.W.; Bruns, T.D. Airborne bacterial communities in residences: Similarities and differences with fungi. PLoS ONE 2014, 9, e91283. [CrossRef] [PubMed] 46. Prussin, A.J.; Marr, L.C. Sources of airborne microorganisms in the built environment. Microbiome 2015, 3, 78. [CrossRef] [PubMed] 47. Wai Tham, K. Indoor air quality and its effects on humans—A review of challenges and developments in the last 30 years. Energy Build. 2016, 130, 637–650. [CrossRef] 48. Uhrbrand, K.; Schultz, A.C.; Koivisto, A.J.; Nielsen, U.; Madsen, A.M. Assessment of airborne bacteria and noroviruses in air emission from a new highly-advanced hospital wastewater treatment plant. Water Res. 2017, 112, 110–119. [CrossRef] [PubMed] 49. Alonso, C.; Raynor, P.C.; Davies, P.R.; Torremorell, M. Concentration, size distribution, and infectivity of airborne particles carrying swine viruses. PLoS ONE 2015, 10, e0135675. [CrossRef] [PubMed] 50. Pastuszka, J.S.; Kyaw Tha Paw, U.; Lis, D.O.; Wlazło, A.; Ulfig, K. Bacterial and fungal aerosol in indoor environment in Upper Silesia, Poland. Atmos. Environ. 2000, 34, 3833–3842. [CrossRef] 51. Asif, A.; Zeeshan, M.; Hashmi, I.; Zahid, U.; Bhatti, M.F. Microbial quality assessment of indoor air in a large hospital building during winter and spring seasons. Build. Environ. 2018, 135, 68–73. [CrossRef] 52. Zhang, Y.; Fu, Y.; Yu, J.; Ai, Q.; Li, J.; Peng, N.; Song, S.; He, Y.; Wang, Z. Synergy of ambroxol with vancomycin in elimination of catheter-related Staphylococcus epidermidis biofilm in vitro and in vivo. J. Infect. Chemother. 2015, 21, 808–815. [CrossRef] [PubMed] 53. Hardjawinata, K.; Setiawati, R.; Dewi, W. Bactericidal efficacy of ultraviolet irradiation on Staphylococcus aureus. Asian J. Oral Maxillofac. Surg. 2005, 17, 157–161. [CrossRef] 54. Sohn, K.M.; Baek, J.Y.; Kim, S.H.; Cheon, S.; Kim, Y.S. Catheter-related bacteremia caused by kocuria salsicia: The first case. J. Infect. Chemother. 2015, 21, 305–307. [CrossRef] 55. Uekotter, A.; Konig, J.; Peters, G.; Becker, K. Port-Infection Due to Kocuria Rhizophila in an 8 Year Old Child with Methylmalonic Aciduria. In Proceedings of the 58th Annual Conference of the German Society of Hygiene and Microbiology, Wurzburg, Germany, 1–4 October 2006. 56. Gholami, M.; Etemadifar, Z.; Bouzari, M. Isolation a new strain of Kocuria rosea capable of tolerating extreme conditions. J. Environ. Radioact. 2015, 144, 113–119. [CrossRef] [PubMed] 57. Xaplanteri, P.; Chondroleou, A.; Kolonitsiou, F.; Skintzi, A.; Anastassiou, E.D.; Marangos, M.; Spiliopoulou, I. Postpartum bacteraemia outbreak due to Bacillus cereus in the delivery room. New Microbes New Infect. 2019, 29, 100510. [CrossRef] [PubMed] 58. De La Rosa, M.C.; Mosso, M.A.; Ullán, C. El aire: Hábitat y medio de transmisión de microorganismos. Obs. Medioambient. 2002, 5, 28. 59. Shivamurthy, V.M.; Gantt, S.; Reilly, C.; Tilley, P.; Guzman, J.; Tucker, L. Bacillus pumilus Septic Arthritis in a Healthy Child. Can. J. Infect. Dis. Med. Microbiol. 2016, 2016, 3265037. [CrossRef] [PubMed] 60. Yuan, Y.; Gao, M. Genomic analysis of a ginger pathogen Bacillus pumilus providing the understanding to the pathogenesis and the novel control strategy. Sci. Rep. 2015, 5, 10259. [CrossRef] [PubMed] 61. Kimouli, M.; Vrioni, G.; Papadopoulou, M.; Koumaki, V.; Petropoulou, D.; Gounaris, A.; Friedrich, A.W.; Tsakris, A. Two cases of severe sepsis caused by Bacillus pumilus in neonatal infants. J. Med. Microbiol. 2012, 61, 596–599. [CrossRef] [PubMed] 62. Celandroni, F.; Salvetti, S.; Gueye, S.A.; Mazzantini, D.; Lupetti, A.; Senesi, S.; Ghelardi, E. Identification and pathogenic potential of clinical Bacillus and Paenibacillus isolates. PLoS ONE 2016, 11, e0152831. [CrossRef] [PubMed] 63. Camacho, R.; Aguilar, E.M.; Quezada, H.; Medina, Ó.; Patiño, G.; Cárdenas, H.M.; Ramos, R. Characterization of Cry toxins from autochthonous Bacillus thuringiensis isolates from Mexico. Bol. Med. Hosp. Infant. Mex. 2017, 74, 193–199. 64. Oggioni, M.R.; Pozzi, G.; Valensin, P.E.; Galieni, P.; Bigazzi, C. Recurrent septicemia in an immunocompromised patient due to probiotic strains of Bacillus subtilis. J. Clin. Microbiol. 1998, 36, 325–326. 65. Sheikh, A.F.; Saki, N.; Roointan, M.; Ranjbar, R.; Yadyad, M.J.; Kaydani, A.; Aslani, S.; Babaei, M.; Goodarzi, H. Identification of Alloiococcus otitidis, Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae in children with otitis media with effusion. Jundishapur J. Microbiol. 2015, 8, e17985. 66. Tano, K.; Von Essen, R.; Eriksson, P.O.; Sjöstedt, A. Alloiococcus otitidis—Otitis media pathogen or normal bacterial flora? APMIS 2008, 116, 785–790. [CrossRef] [PubMed] 67. Harimaya, A.; Takada, R.; Somekawa, Y.; Fujii, N.; Himi, T. High frequency of Alloiococcus otitidis in the nasopharynx and in the middle ear cavity of otitis-prone children. Int. J. Pediatr. Otorhinolaryngol. 2006, 70, 1009–1014. [CrossRef] [PubMed] 68. Hage, J.E.; Schoch, P.E.; Cunha, B.A. Pseudomonas pseudoalcaligenes peritoneal dialysis-associated peritonitis. Perit. Dial. Int. 2013, 33, 223–224. [CrossRef] 69. Sulpher, J.; Desjardins, M.; Lee, B.C. Central venous catheter-associated Leifsonia aquatica bacteremia in a hemodialysis-dependent patient. Diagn. Microbiol. Infect. Dis. 2008, 61, 64–66. [CrossRef] [PubMed] 70. Kolata, J.; Bode, L.; Holtfreter, S.; Steil, L.; Kusch, H.; Holtfreter, B.; Hecker, M.; Engelmann, S.; van Belkum, A.; Völker, U.; et al. The Human Antibody Response to Staphylococcus Aureus Bacteremia. In Proceedings of the 63rd Annual meeting of the German Society for Hygiene and Microbiology, Essen, Germany, 25–28 September 2011. 71. Orden-Martínez, B.; Martínez-Ruiz, R.; Millán-Pérez, R. ¿Qué estamos aprendiendo de Staphylococcus saprophyticus? Enferm. Infecc. Microbiol. Clin. 2008, 26, 495–499. [CrossRef] 72. Ziebuhr, W.; Hennig, S.; Eckart, M.; Kränzler, H.; Batzilla, C.; Kozitskaya, S. Nosocomial infections by Staphylococcus epidermidis: How a commensal bacterium turns into a pathogen. Int. J. Antimicrob. Agents 2006, 28, 14–20. [CrossRef] 73. Sabaté Brescó, M.; Harris, L.G.; Thompson, K.; Stanic, B.; Morgenstern, M.; O’Mahony, L.; Richards, R.G.; Moriarty, T.F. Pathogenic Mechanisms and Host Interactions in Staphylococcus epidermidis Device-Related Infection. Front. Microbiol. 2017, 8, 1401. [CrossRef] 74. Dong, Y.; Speer, C.P. The role of Staphylococcus epidermidis in neonatal sepsis: Guarding angel or pathogenic devil? Int. J. Med. Microbiol. 2014, 304, 513–520. [CrossRef] [PubMed] 75. Thompson, K.A.; Bennett, A.M.; Walker, J.T. Aerosol survival of Staphylococcus epidermidis. J. Hosp. Infect. 2011, 78, 216–220. [CrossRef] 76. Borrego, S.C.; Perdomo, I.; De la Paz, J.; Gómez de Saravia, S.; Guiamet, P. Relevamiento microbiológico del aire y de materiales almacenados en el Archivo Histórico del Museo de La Plata, Argentina y en el Archivo Nacional de la República de Cuba. Rev. Del Mus. La Plata 2011, 18, 1–18. 77. Jadhav, A.R.; Belfort, M.A.; Dildy, G.A. Eikenella corrodens chorioamnionitis: Modes of infection? Am. J. Obstet. Gynecol. 2009, 200, e4–e5. [CrossRef] [PubMed] 78. Sweidan, A.; Chollet-Krugler, M.; Sauvager, A.; van de Weghe, P.; Chokr, A.; Bonnaure-Mallet, M.; Tomasi, S.; Bousarghin, L. Antibacterial activities of natural lichen compounds against Streptococcus gordonii and Porphyromonas gingivalis. Fitoterapia 2017, 121, 164–169. [CrossRef] [PubMed] 79. Nayar, G.; Darley, E.S.R.; Hammond, F.; Matthews, S.; Turton, J.; Wach, R. Does screening neonates in the neonatal intensive care unit for Pseudomonas aeruginosa colonization help prevent infection? J. Hosp. Infect. 2018, 100, 54–59. [CrossRef] [PubMed] 80. Macedo, M.; Blanco, J. Infecciones hospitalarias. Control 2008, 245–254. 81. Soldera, J.; Nedel, W.L.; Cardoso, P.R.; d’Azevedo, P.A. Bacteremia due to Staphylococcus cohnii ssp. urealyticus caused by infected pressure ulcer: Case report and review of the literature. Sao Paulo Med. J. 2013, 131, 59–61. [CrossRef] [PubMed] 82. Mendoza, S.; Garcia, J.; Morfín, R.; Villarreal, L.; Camacho, A.; Rodríguez, E.; Bocanegra, P.; Maldonado, H.; Dowd, S.; Garza, E. Draft genome sequences of two opportunistic pathogenic strains of Staphylococcus cohnii isolated from human patients. Stand. Genomic Sci. 2017, 12. 83. Shahandeh, Z.; Shafi, H.; Sadighian, F. Association of staphylococcus cohnii subspecies urealyticum infection with recurrence of renal staghorn stone. J. Intern. Med. 2015, 6, 40–42. 84. Paul, M.; Gupta, R.; Khush, S.; Thakur, R. Kocuria rosea: An emerging pathogen in acute bacterial meningitisCase report. J. Microbiol. Antimicrob. Agents 2015, 1, 4–7. 85. Moreira, J.S.; Riccetto, A.G.L.; da Silva, M.T.N.; dos Santos Vilela, M.M. Endocarditis by Kocuria rosea in an immunocompetent child. Braz. J. Infect. Dis. 2015, 19, 82–84. [CrossRef] [PubMed] 86. Corti, M.; Villafañe, M.F.; Soto, I.; Palmieri, O.; Callejo, R. Bacteriemia por Kocuria rosea en un paciente con SIDA. Rev. Chil. Infectología 2012, 29, 355–356. [CrossRef] [PubMed] 87. Hilliard, N.J.; Schelonka, R.L.; Waites, K.B. Bacillus cereus bacteremia in a preterm neonate. J. Clin. Microbiol. 2003, 41, 3441–3444. [CrossRef] [PubMed] 88. Machado, C.; Silva, A.; Magalhães, M.J.; Sá, C.; Abreu, E. Severe Bacillus cereus infection in a neonatal intensive care unit. Case Rep. Perinat. Med 2014, 3, 159–162. [CrossRef] 89. Puvabanditsin, S.; Zaafran, A.; Garrow, E.; Diwan, R.; Mehta, D.; Phattraprayoon, N. Bacillus cereus meningoencephalitis in a neonate. Hong Kong J. Paediatr. 2007, 12, 293–296. 90. Venkatesh, M.P.; Placencia, F.; Weisman, L.E. Coagulase-Negative Staphylococcal Infections in the Neonate and Child: An Update. Semin. Pediatr. Infect. Dis. 2006, 17, 120–127. [CrossRef] [PubMed] 91. Yusef, D.; Shalakhti, T.; Awad, S.; Algharaibeh, H.; Khasawneh, W. Clinical characteristics and epidemiology of sepsis in the neonatal intensive care unit in the era of multi-drug resistant organisms: A retrospective review. Pediatr. Neonatol. 2018, 59, 35–41. [CrossRef] [PubMed] 92. Puzari, M.; Sharma, M.; Chetia, P. Emergence of antibiotic resistant Shigella species: A matter of concern. J. Infect. Public Health 2018, 11, 451–454. [PubMed] 93. Boletín epidemiológico de resistencia bacteriana—SIVIBAC año 2014. Available online: http://www.saludcapital. gov.co/DSP/Boletines%20temticos/IAAS/2014/Bolet%C3%ADn%20Resistencia%20Bacteriana%202014.pdf (accessed on 17 May 2019). 94. Monteil, H.; Harf-Monteil, C. Aerobic gram-negative bacilli: Newer nosocomial pathogens. Int. J. Antimicrob. Agents 1997, 8, 217–231. [CrossRef] 95. Klingenberg, C.; Rønnestad, A.; Anderson, A.S.; Abrahamsen, T.G.; Zorman, J.; Villaruz, A.; Flaegstad, T.; Otto, M.; Sollid, J.E. Persistent strains of coagulase-negative staphylococci in a neonatal intensive care unit: Virulence factors and invasiveness. Clin. Microbiol. Infect. 2007, 13, 1100–1111. [CrossRef] 96. Trubiano, J.A.; Padiglione, A.A. Nosocomial infections in the intensive care unit. Anaesth. Intensive Care Med. 2015, 16, 598–602. [CrossRef] |
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MORGADO GAMERO, WENDY BEATRIZMendoza Hernandez, MarthaCastillo Ramirez, MargaritaMEDINA ALTAHONA, JHORMA JOSELa Hoz Theuer, StephaniePosso Mendoza, HeidyParody, AlexanderTeixeira, Elba C.Agudelo-Castañeda, Dayana Milena2019-10-02T15:29:12Z2019-10-02T15:29:12Z2019-09-101661-78271660-4601https://hdl.handle.net/11323/5393Corporación Universidad de la CostaREDICUC - Repositorio CUChttps://repositorio.cuc.edu.co/Despite their significant impact on public health, antibiotic resistance and size distributions of airborne viable bacteria in indoor environments in neonatal intensive care units (NICU) remain understudied. Therefore, the objective of this study was to assess the antibiotic resistance of airborne viable bacteria for different sizes (0.65–7 µm) in private-style and public-style neonatal intensive care units (NICU). Airborne bacteria concentrations were assessed by a six-stage Andersen impactor, operating at 28.3 L/min. Public-style NICU revealed higher concentrations of airborne viable bacteria (53.00 to 214.37 CFU/m3) than private-style NICU (151.94–466.43), indicating a possible threat to health. In the public-style NICU, Staphylococcus was the highest bacterial genera identified in the present study, were Staphylococcus saprophyticus and Staphylococcus epidermidis predominated, especially in the second bronchi and alveoli size ranges. Alloiococcus otitidis, Bacillus subtiles, Bacillus thuringiensis, Kocuria rosea, and Pseudomonas pseudoalcaligene, were identified in the alveoli size range. In NICU#2, eight species were identified in the alveoli size range: Bacillus cereus, Bacillus subtilis, Bacillus thuringiensis, Eikenella corrodens, Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus gordoni. Multi-drug-resistant organisms (MDROs) were found in both of the NICUs. Bacillus cereus strains were resistant to Ampicillin, Cefoxitin, Ceftaroline, and Penicillin G. Staphylococcus cohnii ssp. cohnii was resistant in parallel to ampicillin and G penicillin. Staphylococcus saprophyticus strains were resistant to Ampicillin, Penicillin G, Oxaxilin, and Erythromycin. Results may indicate a potential threat to human health due to the airborne bacteria concentration and their antibiotic resistance ability. The results may provide evidence for the need of interventions to reduce indoor airborne particle concentrations and their transfer to premature infants with underdeveloped immune systems, even though protocols for visitors and cleaning are well-established.MORGADO GAMERO, WENDY BEATRIZ-will be generated-orcid-0000-0003-2394-2589-600Mendoza Hernandez, MarthaCastillo Ramirez, MargaritaMEDINA ALTAHONA, JHORMA JOSE-will be generated-orcid-0000-0002-3683-6905-600La Hoz Theuer, Stephanie-will be generated-orcid-0000-0001-5606-655X-600Posso Mendoza, HeidyParody, AlexanderTeixeira, Elba C.Agudelo-Castañeda, Dayana Milena-will be generated-orcid-0000-0002-6589-6835-600engInternational Journal of Environmental Research and Public Healthhttps://doi.org/10.3390/ijerph161833401. Gao, M.; Yan, X.; Qiu, T.; Han, M.; Wang, X. Variation of correlations between factors and culturable airborne bacteria and fungi. Atmos. Environ. 2016, 128, 10–19. [CrossRef] 2. Jara Hernández, E.L.; Piraquive Mórtola, J.S. Determinación de la Calidad de Aire Intrmural en la Clínica Veterinaria, Universidad de la Salle; Universidad de la Salle: Bogotá, Colombia, 2016. 3. Kim, K.H.; Kabir, E.; Jahan, S.A. Airborne bioaerosols and their impact on human health. J. Environ. Sci. (China) 2018, 67, 23–35. [CrossRef] [PubMed] 4. Yao, M.; Colbeck, I.; Lazaridis, M.; Liu, K.F.; Hung, M.; Shen, Y.; Reijula, K.; Tringe, S.G.; Zhang, T.; Liu, X.; et al. Bioaerosol: A bridge and opportunity for many scientific research fields. J. Aerosol Sci. 2018, 115, 108–112. [CrossRef] 5. Smets, W.; Moretti, S.; Denys, S.; Lebeer, S. Airborne bacteria in the atmosphere: Presence, purpose, and potential. Atmos. Environ. 2016, 139, 214–221. [CrossRef] 6. Fröhlich-Nowoisky, J.; Kampf, C.J.; Weber, B.; Huffman, J.A.; Pöhlker, C.; Andreae, M.O.; Lang-Yona, N.; Burrows, S.M.; Gunthe, S.S.; Elbert, W.; et al. Bioaerosols in the Earth system: Climate, health, and ecosystem interactions. Atmos. Res. 2016, 182, 346–376. [CrossRef] 7. Walser, S.M.; Gerstner, D.G.; Brenner, B.; Bünger, J.; Eikmann, T.; Janssen, B.; Kolb, S.; Kolk, A.; Nowak, D.; Raulf, M.; et al. Evaluation of exposure-response relationships for health effects of microbial bioaerosols - A systematic review. Int. J. Hyg. Environ. Health 2015, 218, 577–589. [CrossRef] 8. Edith, G.; Espinoza, C. Determinación de Organismos Mesófilos Aerobios en el Ambiente de Cd. Obregón, Sonora; Mediante el uso del Monitor aéreo Microbiológico y Método de Cuenta en Placa Abierta. Available online: https://docplayer.es/42154583-Tesis-que-para-obtener-el-titulo-de-ingeniero-biotecnologo-presentagloria-edith-camacho-espinoza.html (accessed on 17 May 2019). 9. Pelczar, M.J.; Chan, E.C.S.; Krieg, N.R. Microbiology, 5th ed.; Tata Mc Graw Hill: New York, NY, USA, 1993. 10. Cabo Verde, S.; Almeida, S.M.; Matos, J.; Guerreiro, D.; Meneses, M.; Faria, T.; Botelho, D.; Santos, M.; Viegas, C. Microbiological assessment of indoor air quality at different hospital sites. Res. Microbiol. 2015, 166, 557–563. [CrossRef] 11. Abdel-Wahab, F.; Ghoneim, M.; Khashaba, M.; El-Gilany, A.-H.; Abdel-Hady, D. Nosocomial infection surveillance in an Egyptian neonatal intensive care unit. J. Hosp. Infect. 2013, 83, 196–199. [CrossRef] 12. Youn, K.; Shin, Y. Daekeun Distribution characteristics of airborne bacteria and fungi in the general hospitals of Korea. Ind. Health 2010, 48, 236–243. 13. Jaffal, A.A.; Nsanze, H.; Bener, A.; Ameen, A.S.; Banat, I.M.; Mogheth, A.A. El Hospital airborne microbial pollution in a desert country. Environ. Int. 1997, 23, 167–172. [CrossRef] 14. Hernandez, M.; León, S. Determinación de la Calidad del Aire Extramural E Intramural en la Sala de Cirugía del Hospital el Tunal de la Cuidad De Bogotá Para el Desarrollo de Mecanismos de Control y Minimización De Riesgo Causado por Microorganismos Potencialmente Nosocomiales. Available online: http://repository. lasalle.edu.co/bitstream/handle/10185/14040/T41.08%20H43d.pdf?sequence=1&isAllowed=y (accessed on 17 May 2019). 15. Leung, M.; Chan, A.H.S. Control and management of hospital indoor air quality. Med. Sci. Monit. 2006, 12, SR17–SR23. 16. Coronell, W.; Rojas, J.; Escamilla, M.; Manotas, M.; Sánchez, M. Infección Nosocomial En Unidades de Cuidados Intensivos Neonatales. Precop. Scp. 2010, 9, 30–39. 17. Morgado Gamero, W.B.; Ramírez, M.C.; Parody, A.; Viloria, A.; López, M.H.A.; Kamatkar, S.J. Concentrations and Size Distributions of Fungal Bioaerosols in a Municipal Landfill. In Data Mining and Big Data; Tan, Y., Shi, Y., Tang, Q., Eds.; Springer International Publishing: Cham, Switzerland, 2018; pp. 244–253. 18. Zhu, H.; Phelan, P.; Duan, T.; Raupp, G.; Fernando, H.J.S. Characterizations and relationships between outdoor and indoor bioaerosols in an office building. China Particuology 2003, 1, 119–123. [CrossRef] 19. Wang, W.; Ma, Y.; Ma, X.; Wu, F.; Ma, X.; An, L.; Feng, H. Diversity and seasonal dynamics of airborne bacteria in the Mogao Grottoes, Dunhuang, China. Aerobiologia 2012, 28, 27–38. [CrossRef] 20. Claudia Andrea, C.T. Evaluación del Comportamiento de Aerobacterias en el Corregimiento de Cuatro Bocas. Tubará, Atlántico. Available online: https://www.researchgate.net/profile/Wendy_Morgado_ Gamero/publication/325478384_EVALUATION_OF_THE_BEHAVIOR_OF_AIRBORNE_BACTERIA_ IN_THE_VILLAGE_OF_CUATRO_BOCAS_TUBARA_ATLANTICO/links/5b106cdea6fdcc4611d977e4/ EVALUATION-OF-THE-BEHAVIOR-OF-AIRBORNE-BACTERIA-IN-THE-VILLAGE-OF-CUATROBOCAS-TUBARA-ATLANTICO.pdf?origin=publication_detail (accessed on 17 May 2019). 21. Ortiz, J.; Préndez Bolívar, M.M.; Solezzi, S. Utilizacion y manejo de un impactador de cascada ANDERSEN en el estudio de los aerosoles atmosfericos. Medio Ambiente 1986, 8, 3–8. 22. Heo, Y.; Park, J.; Lim, S.; Hur, H.; Kim, D.; Park, K. Size-resolved culturable airborne bacteria sampled in rice field, sanitary landfill, and waste incineration sites. J. Environ. Monit. 2010, 12, 1619. [CrossRef] [PubMed] 23. Li, C.S.; Hou, P.A. Bioaerosol characteristics in hospital clean rooms. Sci. Total Environ. 2003, 305, 169–176. [CrossRef] 24. Morgado Gamero, W.B.; Agudelo-Castañeda, D.; Ramirez, M.C.; Hernandez, M.M.; Mendoza, H.P.; Parody, A.; Viloria, A. Hospital Admission and Risk Assessment Associated to Exposure of Fungal Bioaerosols at a Municipal Landfill Using Statistical Models. In Intelligent Data Engineering and Automated Learning—IDEAL 2018; Yin, H., Camacho, D., Novais, P., Tallón-Ballesteros, A.J., Eds.; Springer International Publishing: Cham, Switzerland, 2018; pp. 210–218. 25. Ghosh, B.; Lal, H.; Srivastava, A. Review of bioaerosols in indoor environment with special reference to sampling, analysis and control mechanisms. Environ. Int. 2015, 85, 254–272. [CrossRef] 26. Kim, K.Y.; Kim, C.N. Airborne microbiological characteristics in public buildings of Korea. Build. Environ. 2007, 42, 2188–2196. [CrossRef] 27. Awad, A.H.; Saeed, Y.; Hassan, Y.; Fawzy, Y.; Osman, M. Air microbial quality in certain public buildings, Egypt: A comparative study. Atmos. Pollut. Res. 2018, 9, 617–626. [CrossRef] 28. He, C.; Mackay, I.M.; Ramsay, K.; Liang, Z.; Kidd, T.; Knibbs, L.D.; Johnson, G.; McNeale, D.; Stockwell, R.; Coulthard, M.G.; et al. Particle and bioaerosol characteristics in a paediatric intensive care unit. Environ. Int. 2017, 107, 89–99. [CrossRef] [PubMed] 29. Licina, D.; Bhangar, S.; Brooks, B.; Baker, R.; Firek, B.; Tang, X.; Morowitz, M.J.; Banfield, J.F.; Nazaroff, W.W. Concentrations and sources of airborne particles in a neonatal intensive care unit. PLoS ONE 2016, 11, e0154991. [CrossRef] [PubMed] 30. Berenguer, J.; Sanz, J.L. Cuestiones en Microbiología; Editorial Hélice: Madrid, Spain, 2004. 31. Maldonado-Vega, M.; Peña-Cabriales, J.J.; De los Santos, S.; Castellanos-Arévalo, A.P.; Camarena-Pozos, D.; Arévalo-Rivas, B.; Valdés-Santiago, L.; Hernández-Valadez, L.J.; Guzmán De Peña, D.L. Bioaerosoles y evaluación de la calidad del aire en dos centros hospitalarios ubicados en León, Guanaguato, México (Bioaerosols and air quality assessment in two hospitals located in León, Guanajuato, Mexico). Rev. Int. Contam. Ambient 2014, 30, 351–363. 32. SAMPSP (Sociedad Andaluza de Medicina Preventiva y Salud Pública). Recomendaciones Para la Monitorización de la Calidad Microbiológica del Aire (Bioseguridad Ambiental) en Zonas Hospitalarias de Riesgo; SAMPSP: Andalucía, Spain, 2016; pp. 1–35. 33. Colombia. Ministerio de Salud y Protección Social Resolución 002003 de 2014. Available online: https: //www.minsalud.gov.co/Normatividad_Nuevo/Resoluci%C3%B3n%202003%20de%202014.pdf (accessed on 17 May 2019). 34. Macher, J.M.; Chatigny, M.A.; Burge, H.A. Sampling Airborne Microorganisms and Aeroallergens. In Air Sampling Instruments for Evaluation of Atmospheric Contaminan; ACGIH: Cincinnati, OH, USA, 1995; pp. 589–617. 35. Rao, C.Y.; Burge, H.A.; Chang, J.C. Review of quantitative standards and guidelines for fungi in indoor air. J. Air Waste Manag. Assoc. 1996, 46, 899–908. [CrossRef] 36. IAQA (Indoor Air Quality Association). Indoor Air Quality Standard #95-1 Recommended for Florida; IAQA: Longwood, FL, USA, 1995. 37. Heida, H.; Bartman, F.; van der Zee, S.C. Occupational Exposure and Indoor Air Quality Monitoring in a Composting Facility. Am. Ind. Hyg. Assoc. J. 1995, 56, 39–43. [CrossRef] 38. OSHA (Occupational Safety and Health Administration). Indoor Air Quality; OSHA: Washington, DC, USA, 1994; pp. 15968–16039. 39. Aryanna Kelly Pinheiro, S. Microbiota Fúngica do Ambiente da uti Neonatal e de Amostras Clínicas dos Recém-Nascidos Internados no Hospital Universitário de Maceió. Master’s Thesis, Universidade Federal de Alagoas, Maceio, Brazil, 2009. 40. Viegas, C.; Faria, T.; dos Santos, M.; Carolino, E.; Gomes, A.Q.; Sabino, R.; Viegas, S. Fungal burden in waste industry: An occupational risk to be solved. Environ. Monit. Assess. 2015, 187, 199. [CrossRef] 41. Yamamoto, N.; Schmechel, D.; Chen, B.T.; Lindsley, W.G.; Peccia, J. Comparison of quantitative airborne fungi measurements by active and passive sampling methods. J. Aerosol Sci. 2011, 42, 499–507. [CrossRef] 42. Sady´s, M.; Kennedy, R.; West, J.S. Potential impact of climate change on fungal distributions: Analysis of 2 years of contrasting weather in the UK. Aerobiologia 2016, 32, 127–137. [CrossRef] 43. Dungan, R.S. Board-invited review: Fate and transport of bioaerosols associated with livestock operations and manures. J. Anim. Sci. 2010, 88, 3693–3706. [CrossRef] 44. Pahari, A.K.; Dasgupta, D.; Patil, R.S.; Mukherji, S. Emission of bacterial bioaerosols from a composting facility in Maharashtra, India. Waste Manag. 2016, 53, 22–31. [CrossRef] 45. Adams, R.I.; Miletto, M.; Lindow, S.E.; Taylor, J.W.; Bruns, T.D. Airborne bacterial communities in residences: Similarities and differences with fungi. PLoS ONE 2014, 9, e91283. [CrossRef] [PubMed] 46. Prussin, A.J.; Marr, L.C. Sources of airborne microorganisms in the built environment. Microbiome 2015, 3, 78. [CrossRef] [PubMed] 47. Wai Tham, K. Indoor air quality and its effects on humans—A review of challenges and developments in the last 30 years. Energy Build. 2016, 130, 637–650. [CrossRef] 48. Uhrbrand, K.; Schultz, A.C.; Koivisto, A.J.; Nielsen, U.; Madsen, A.M. Assessment of airborne bacteria and noroviruses in air emission from a new highly-advanced hospital wastewater treatment plant. Water Res. 2017, 112, 110–119. [CrossRef] [PubMed] 49. Alonso, C.; Raynor, P.C.; Davies, P.R.; Torremorell, M. Concentration, size distribution, and infectivity of airborne particles carrying swine viruses. PLoS ONE 2015, 10, e0135675. [CrossRef] [PubMed] 50. Pastuszka, J.S.; Kyaw Tha Paw, U.; Lis, D.O.; Wlazło, A.; Ulfig, K. Bacterial and fungal aerosol in indoor environment in Upper Silesia, Poland. Atmos. Environ. 2000, 34, 3833–3842. [CrossRef] 51. Asif, A.; Zeeshan, M.; Hashmi, I.; Zahid, U.; Bhatti, M.F. Microbial quality assessment of indoor air in a large hospital building during winter and spring seasons. Build. Environ. 2018, 135, 68–73. [CrossRef] 52. Zhang, Y.; Fu, Y.; Yu, J.; Ai, Q.; Li, J.; Peng, N.; Song, S.; He, Y.; Wang, Z. Synergy of ambroxol with vancomycin in elimination of catheter-related Staphylococcus epidermidis biofilm in vitro and in vivo. J. Infect. Chemother. 2015, 21, 808–815. [CrossRef] [PubMed] 53. Hardjawinata, K.; Setiawati, R.; Dewi, W. Bactericidal efficacy of ultraviolet irradiation on Staphylococcus aureus. Asian J. Oral Maxillofac. Surg. 2005, 17, 157–161. [CrossRef] 54. Sohn, K.M.; Baek, J.Y.; Kim, S.H.; Cheon, S.; Kim, Y.S. Catheter-related bacteremia caused by kocuria salsicia: The first case. J. Infect. Chemother. 2015, 21, 305–307. [CrossRef] 55. Uekotter, A.; Konig, J.; Peters, G.; Becker, K. Port-Infection Due to Kocuria Rhizophila in an 8 Year Old Child with Methylmalonic Aciduria. In Proceedings of the 58th Annual Conference of the German Society of Hygiene and Microbiology, Wurzburg, Germany, 1–4 October 2006. 56. Gholami, M.; Etemadifar, Z.; Bouzari, M. Isolation a new strain of Kocuria rosea capable of tolerating extreme conditions. J. Environ. Radioact. 2015, 144, 113–119. [CrossRef] [PubMed] 57. Xaplanteri, P.; Chondroleou, A.; Kolonitsiou, F.; Skintzi, A.; Anastassiou, E.D.; Marangos, M.; Spiliopoulou, I. Postpartum bacteraemia outbreak due to Bacillus cereus in the delivery room. New Microbes New Infect. 2019, 29, 100510. [CrossRef] [PubMed] 58. De La Rosa, M.C.; Mosso, M.A.; Ullán, C. El aire: Hábitat y medio de transmisión de microorganismos. Obs. Medioambient. 2002, 5, 28. 59. Shivamurthy, V.M.; Gantt, S.; Reilly, C.; Tilley, P.; Guzman, J.; Tucker, L. Bacillus pumilus Septic Arthritis in a Healthy Child. Can. J. Infect. Dis. Med. Microbiol. 2016, 2016, 3265037. [CrossRef] [PubMed] 60. Yuan, Y.; Gao, M. Genomic analysis of a ginger pathogen Bacillus pumilus providing the understanding to the pathogenesis and the novel control strategy. Sci. Rep. 2015, 5, 10259. [CrossRef] [PubMed] 61. Kimouli, M.; Vrioni, G.; Papadopoulou, M.; Koumaki, V.; Petropoulou, D.; Gounaris, A.; Friedrich, A.W.; Tsakris, A. Two cases of severe sepsis caused by Bacillus pumilus in neonatal infants. J. Med. Microbiol. 2012, 61, 596–599. [CrossRef] [PubMed] 62. Celandroni, F.; Salvetti, S.; Gueye, S.A.; Mazzantini, D.; Lupetti, A.; Senesi, S.; Ghelardi, E. Identification and pathogenic potential of clinical Bacillus and Paenibacillus isolates. PLoS ONE 2016, 11, e0152831. [CrossRef] [PubMed] 63. Camacho, R.; Aguilar, E.M.; Quezada, H.; Medina, Ó.; Patiño, G.; Cárdenas, H.M.; Ramos, R. Characterization of Cry toxins from autochthonous Bacillus thuringiensis isolates from Mexico. Bol. Med. Hosp. Infant. Mex. 2017, 74, 193–199. 64. Oggioni, M.R.; Pozzi, G.; Valensin, P.E.; Galieni, P.; Bigazzi, C. Recurrent septicemia in an immunocompromised patient due to probiotic strains of Bacillus subtilis. J. Clin. Microbiol. 1998, 36, 325–326. 65. Sheikh, A.F.; Saki, N.; Roointan, M.; Ranjbar, R.; Yadyad, M.J.; Kaydani, A.; Aslani, S.; Babaei, M.; Goodarzi, H. Identification of Alloiococcus otitidis, Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae in children with otitis media with effusion. Jundishapur J. Microbiol. 2015, 8, e17985. 66. Tano, K.; Von Essen, R.; Eriksson, P.O.; Sjöstedt, A. Alloiococcus otitidis—Otitis media pathogen or normal bacterial flora? APMIS 2008, 116, 785–790. [CrossRef] [PubMed] 67. Harimaya, A.; Takada, R.; Somekawa, Y.; Fujii, N.; Himi, T. High frequency of Alloiococcus otitidis in the nasopharynx and in the middle ear cavity of otitis-prone children. Int. J. Pediatr. Otorhinolaryngol. 2006, 70, 1009–1014. [CrossRef] [PubMed] 68. Hage, J.E.; Schoch, P.E.; Cunha, B.A. Pseudomonas pseudoalcaligenes peritoneal dialysis-associated peritonitis. Perit. Dial. Int. 2013, 33, 223–224. [CrossRef] 69. Sulpher, J.; Desjardins, M.; Lee, B.C. Central venous catheter-associated Leifsonia aquatica bacteremia in a hemodialysis-dependent patient. Diagn. Microbiol. Infect. Dis. 2008, 61, 64–66. [CrossRef] [PubMed] 70. Kolata, J.; Bode, L.; Holtfreter, S.; Steil, L.; Kusch, H.; Holtfreter, B.; Hecker, M.; Engelmann, S.; van Belkum, A.; Völker, U.; et al. The Human Antibody Response to Staphylococcus Aureus Bacteremia. In Proceedings of the 63rd Annual meeting of the German Society for Hygiene and Microbiology, Essen, Germany, 25–28 September 2011. 71. Orden-Martínez, B.; Martínez-Ruiz, R.; Millán-Pérez, R. ¿Qué estamos aprendiendo de Staphylococcus saprophyticus? Enferm. Infecc. Microbiol. Clin. 2008, 26, 495–499. [CrossRef] 72. Ziebuhr, W.; Hennig, S.; Eckart, M.; Kränzler, H.; Batzilla, C.; Kozitskaya, S. Nosocomial infections by Staphylococcus epidermidis: How a commensal bacterium turns into a pathogen. Int. J. Antimicrob. Agents 2006, 28, 14–20. [CrossRef] 73. Sabaté Brescó, M.; Harris, L.G.; Thompson, K.; Stanic, B.; Morgenstern, M.; O’Mahony, L.; Richards, R.G.; Moriarty, T.F. Pathogenic Mechanisms and Host Interactions in Staphylococcus epidermidis Device-Related Infection. Front. Microbiol. 2017, 8, 1401. [CrossRef] 74. Dong, Y.; Speer, C.P. The role of Staphylococcus epidermidis in neonatal sepsis: Guarding angel or pathogenic devil? Int. J. Med. Microbiol. 2014, 304, 513–520. [CrossRef] [PubMed] 75. Thompson, K.A.; Bennett, A.M.; Walker, J.T. Aerosol survival of Staphylococcus epidermidis. J. Hosp. Infect. 2011, 78, 216–220. [CrossRef] 76. Borrego, S.C.; Perdomo, I.; De la Paz, J.; Gómez de Saravia, S.; Guiamet, P. Relevamiento microbiológico del aire y de materiales almacenados en el Archivo Histórico del Museo de La Plata, Argentina y en el Archivo Nacional de la República de Cuba. Rev. Del Mus. La Plata 2011, 18, 1–18. 77. Jadhav, A.R.; Belfort, M.A.; Dildy, G.A. Eikenella corrodens chorioamnionitis: Modes of infection? Am. J. Obstet. Gynecol. 2009, 200, e4–e5. [CrossRef] [PubMed] 78. Sweidan, A.; Chollet-Krugler, M.; Sauvager, A.; van de Weghe, P.; Chokr, A.; Bonnaure-Mallet, M.; Tomasi, S.; Bousarghin, L. Antibacterial activities of natural lichen compounds against Streptococcus gordonii and Porphyromonas gingivalis. Fitoterapia 2017, 121, 164–169. [CrossRef] [PubMed] 79. Nayar, G.; Darley, E.S.R.; Hammond, F.; Matthews, S.; Turton, J.; Wach, R. Does screening neonates in the neonatal intensive care unit for Pseudomonas aeruginosa colonization help prevent infection? J. Hosp. Infect. 2018, 100, 54–59. [CrossRef] [PubMed] 80. Macedo, M.; Blanco, J. Infecciones hospitalarias. Control 2008, 245–254. 81. Soldera, J.; Nedel, W.L.; Cardoso, P.R.; d’Azevedo, P.A. Bacteremia due to Staphylococcus cohnii ssp. urealyticus caused by infected pressure ulcer: Case report and review of the literature. Sao Paulo Med. J. 2013, 131, 59–61. [CrossRef] [PubMed] 82. Mendoza, S.; Garcia, J.; Morfín, R.; Villarreal, L.; Camacho, A.; Rodríguez, E.; Bocanegra, P.; Maldonado, H.; Dowd, S.; Garza, E. Draft genome sequences of two opportunistic pathogenic strains of Staphylococcus cohnii isolated from human patients. Stand. Genomic Sci. 2017, 12. 83. Shahandeh, Z.; Shafi, H.; Sadighian, F. Association of staphylococcus cohnii subspecies urealyticum infection with recurrence of renal staghorn stone. J. Intern. Med. 2015, 6, 40–42. 84. Paul, M.; Gupta, R.; Khush, S.; Thakur, R. Kocuria rosea: An emerging pathogen in acute bacterial meningitisCase report. J. Microbiol. Antimicrob. Agents 2015, 1, 4–7. 85. Moreira, J.S.; Riccetto, A.G.L.; da Silva, M.T.N.; dos Santos Vilela, M.M. Endocarditis by Kocuria rosea in an immunocompetent child. Braz. J. Infect. Dis. 2015, 19, 82–84. [CrossRef] [PubMed] 86. Corti, M.; Villafañe, M.F.; Soto, I.; Palmieri, O.; Callejo, R. Bacteriemia por Kocuria rosea en un paciente con SIDA. Rev. Chil. Infectología 2012, 29, 355–356. [CrossRef] [PubMed] 87. Hilliard, N.J.; Schelonka, R.L.; Waites, K.B. Bacillus cereus bacteremia in a preterm neonate. J. Clin. Microbiol. 2003, 41, 3441–3444. [CrossRef] [PubMed] 88. Machado, C.; Silva, A.; Magalhães, M.J.; Sá, C.; Abreu, E. Severe Bacillus cereus infection in a neonatal intensive care unit. Case Rep. Perinat. Med 2014, 3, 159–162. [CrossRef] 89. Puvabanditsin, S.; Zaafran, A.; Garrow, E.; Diwan, R.; Mehta, D.; Phattraprayoon, N. Bacillus cereus meningoencephalitis in a neonate. Hong Kong J. Paediatr. 2007, 12, 293–296. 90. Venkatesh, M.P.; Placencia, F.; Weisman, L.E. Coagulase-Negative Staphylococcal Infections in the Neonate and Child: An Update. Semin. Pediatr. Infect. Dis. 2006, 17, 120–127. [CrossRef] [PubMed] 91. Yusef, D.; Shalakhti, T.; Awad, S.; Algharaibeh, H.; Khasawneh, W. Clinical characteristics and epidemiology of sepsis in the neonatal intensive care unit in the era of multi-drug resistant organisms: A retrospective review. Pediatr. Neonatol. 2018, 59, 35–41. [CrossRef] [PubMed] 92. Puzari, M.; Sharma, M.; Chetia, P. Emergence of antibiotic resistant Shigella species: A matter of concern. J. Infect. Public Health 2018, 11, 451–454. [PubMed] 93. Boletín epidemiológico de resistencia bacteriana—SIVIBAC año 2014. Available online: http://www.saludcapital. gov.co/DSP/Boletines%20temticos/IAAS/2014/Bolet%C3%ADn%20Resistencia%20Bacteriana%202014.pdf (accessed on 17 May 2019). 94. Monteil, H.; Harf-Monteil, C. Aerobic gram-negative bacilli: Newer nosocomial pathogens. Int. J. Antimicrob. Agents 1997, 8, 217–231. [CrossRef] 95. Klingenberg, C.; Rønnestad, A.; Anderson, A.S.; Abrahamsen, T.G.; Zorman, J.; Villaruz, A.; Flaegstad, T.; Otto, M.; Sollid, J.E. Persistent strains of coagulase-negative staphylococci in a neonatal intensive care unit: Virulence factors and invasiveness. Clin. Microbiol. Infect. 2007, 13, 1100–1111. [CrossRef] 96. Trubiano, J.A.; Padiglione, A.A. Nosocomial infections in the intensive care unit. Anaesth. Intensive Care Med. 2015, 16, 598–602. 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