Aerosol Bioburden and Antimicrobial Resistance in Orthopaedic Operating Unit in a Tertiary Hospital in Thailand
3
Issued Date
2025-01-01
Resource Type
eISSN
22288082
Scopus ID
2-s2.0-86000750524
Journal Title
Siriraj Medical Journal
Volume
77
Issue
3
Start Page
220
End Page
232
Rights Holder(s)
SCOPUS
Bibliographic Citation
Siriraj Medical Journal Vol.77 No.3 (2025) , 220-232
Suggested Citation
Borwornphiphattanachai K., Ruangchainikom M., Nontarak J., Thongpanich Y., Utrarachkij F. Aerosol Bioburden and Antimicrobial Resistance in Orthopaedic Operating Unit in a Tertiary Hospital in Thailand. Siriraj Medical Journal Vol.77 No.3 (2025) , 220-232. 232. doi:10.33192/smj.v77i3.269624 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/106761
Title
Aerosol Bioburden and Antimicrobial Resistance in Orthopaedic Operating Unit in a Tertiary Hospital in Thailand
Author's Affiliation
Corresponding Author(s)
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Abstract
Objective: This study aimed to determine the microbial indoor air quality and factors associated with bacterial air contamination in the orthopaedic operating unit. Materials and Methods: Conducted in seven operating rooms (ORs) and six surrounding rooms (SRs) in an orthopaedic operating unit. A total of 352 air samples were collected using an Andersen air sampler. Fungal and bacterial counts were determined as air quality indicators. Antimicrobial resistance (AMR) of predominant bacteria and factors influencing microbial air quality were analyzed. Results: Most air samples in the ORs (87.2%) and SRs (81.8%) contained acceptable fungal counts. However, unoccupied ORs (11.1%), occupied ORs (58.1%), and SRs (64.2%) had fewer samples with acceptable bacterial levels. The geometric mean (GM) bacterial load in the ORs before aerosol-generating procedures (AGPs) was 116.8±1.8 CFU/m3, higher than after AGPs (58.9±2.1 CFU/m3). After controlling potentially confounding factors, the factors influencing bacterial loads occupied OR were temperature before AGPs (0.164 CFU/m3, 95%CI 0.017–0.311, p=0.029), the number of staff after AGPs (0.082 CFU/m3, 95%CI 0.019–0.144, p=0.011), and using saw/drill device after AGPs (0.701 CFU/m3, 95%CI -1.326–0.076, p=0.029). Predominant bacteria were Gram-positive cocci (90.8%), of which 20.5% were S. aureus. Most S. aureus (94.2%) were resistant to at least one drug, with 40.7% being multidrug-resistant. Additionally, 33.7% were methicillin-resistant S. aureus (MRSA). Conclusion: The indoor air of ORs and SRs may be a source of AMR bacteria, particularly MRSA, a concern for surgical site infections. Maintaining ventilation, cleanliness, and minimizing non-essential staff activities are crucial for reducing airborne pathogen transmission.