Original Research

Assessment of airborne bacterial and fungal communities in different wards of educational hospitals: A case study in Urmia, Iran


Introduction: Bioaerosols consist of aerosols which are biologically originated and can be present ubiquitously in different environments, including the indoor air of hospitals. The objective of this study was to survey the bioaerosol type and density in various environments of four governmental educational hospitals in Urmia, Iran, namely the intensive care unit (ICU), operating room, the internal medicine room, the infectious diseases room, the infectious diseases corridor, and ambient air.

Materials and methods: Sampling was performed during summer and winter of 2019 at four different day-times using passive (sedimentation plate) and active methods (an Andersen one-stage viable impactor and Quick Take-30 sampling instrument) and by counting plates containing a bacterial and fungus-selective medium.

Results: The results revealed that the highest microbial bioaerosol load was related to the infectious diseases corridor (100 and 150 CFU/m3 for total bacterial and fungal load, respectively). The highest bacterial and fungal density was observed in the afternoon at 17-18; and the concentration of bioaerosols was higher in summer than winter. A comparison of indoor and outdoor bacterial loads showed that the indoor bacterial concentration mean (49.1±23.8 CFU/m3) was higher than the outdoor value (47.1±21.5 CFU/m3), and the indoor levels of fungal contamination (83.3±31.9 CFU/m3) were significantly lower than outdoor values (182.5±48.0 CFU/m3). The predominantly isolated bacteria were Staphylococcus (95%) spp, and the main isolated fungi belong to the genera Aspergillus (50%) and Penicillium (32%).

Conclusion: The results of this study can be useful in developing indoor air microbial quality guidelines in hospitals, which has not been done so far.

1. Morawska L, Ayoko G, Bae G, Buonanno G, Chao C, Clifford S, et al. Airborne particles in indoor environment of homes, schools, offices and aged care facilities: The main routes of exposure. Environment international. 2017;108:75-83.
2. Hsu Y-C, Kung P-Y, Wu T-N, Shen Y-H. Characterization of indoor-air bioaerosols in Southern Taiwan. Aerosol and Air Quality Research. 2012;12(4):651-61.
3. Kalwasinska A, Burkowska A, Wilk I. Microbial air contamination in indoor environment of a university library. Annals of Agricultural and Environmental Medicine. 2012;19(1).
4. Pastuszka J, Marchwinska-Wyrwal E, Wlazlo A. Bacterial aerosol in Silesian hospitals: Preliminary results. Polish Journal of Environmental Studies. 2005;14(6):883.
5. Zorman T, Jeršek B. Assessment of bioaerosol concentrations in different indoor environments. Indoor and Built Environment. 2008;17(2):155-63.
6. Verde SC, Almeida SM, Matos J, Guerreiro D, Meneses M, Faria T, et al. Microbiological assessment of indoor air quality at different hospital sites. Research in Microbiology. 2015;166(7):557-63.
7. Kim KY, Kim YS, Kim D. Distribution characteristics of airborne bacteria and fungi in the general hospitals of Korea. Industrial health. 2010;48(2):236-43.
8. Park D-U, Yeom J-K, Lee WJ, Lee K-M. Assessment of the levels of airborne bacteria, gram-negative bacteria, and fungi in hospital lobbies. International journal of environmental research and public health. 2013;10(2):541-55.
9. Fang Z, Ouyang Z, Hu L, Wang X, Zheng H, Lin X. Culturable airborne fungi in outdoor environments in Beijing, China. Science of the Total Environment. 2005;350(1-3):47-58.
10. Mentese S, Rad AY, Arısoy M, Güllü G. Seasonal and spatial variations of bioaerosols in indoor urban environments, Ankara, Turkey. Indoor and built environment. 2012;21(6):797-810.
11. Obbard JP, Fang LS. Airborne concentrations of bacteria in a hospital environment in Singapore. Water, Air, and Soil Pollution. 2003;144(1-4):333-41.
12. Napoli C, Tafuri S, Montenegro L, Cassano M, Notarnicola A, Lattarulo S, et al. Air sampling methods to evaluate microbial contamination in operating theatres: results of a comparative study in an orthopaedics department. Journal of Hospital Infection. 2012;80(2):128-32.
13. Pasquarella C, Pitzurra O, Savino A. The index of microbial air contamination. Journal of hospital infection. 2000;46(4):241-56.
14. Stryjakowska-Sekulska M, Piotraszewska-Pajak A, Szyszka A, Nowicki M, Filipiak M. Microbiological quality of indoor air in university rooms. Polish Journal of Environmental Studies. 2007;16(4):623.
15. Azimi F, Naddafi K, Nabizadeh R, Hassanvand MS, Alimohammadi M, Afhami S, et al. Fungal air quality in hospital rooms: a case study in Tehran, Iran. Journal of Environmental Health Science and Engineering. 2013;11(1):30.
16. Hoseinzadeh E, Taghavi M, Samarghandie MR. Evaluation of fungal and bacterial aerosols in the different wards of Malayer city’s hospitals in 2011-2012. Journal of Hospital. 2014;13(3):99-108.
17. Ainsworth GC. Introduction to the History of Mycology: Cambridge University Press; 1976.
18. Kim K-H, Kabir E, Jahan SA. Airborne bioaerosols and their impact on human health. Journal of Environmental Sciences. 2018;67:23-35.
19. Wanner H, Verhoeff A, Colombi A, Flanigan B, Gravesen S, Mouilleseaux A, et al. Indoor air quality & its impact on man: Report No. 12: biological particles in indoor environments. ECSC-EEC-EAEC, Brussels-Luxembourg, 1993.
20. Dutkiewicz J, Górny R. Biologic factors hazardous to health: Classification and criteria of exposure assessment. Medycyna pracy. 2002;53(1):29-39.
21. Nevalainen A, Morawaska L. Biological agents in indoor environments. Assessment of health risks. Work conducted by a WHO Expert Group between 2000-2003. World Health Organization Geneva. 2009.
22. Macher J. Sampling airborne microorganisms and aeroallergens. Air sampling instruments for evaluation of atmospheric contaminants. 1995:589-617.
23. Association AIH. Biosafety Committee Biohazards Reference Manual. AIHA, Washington, DC, USA. 1986.
24. Wanner H, Verhoeff A, Colombi A, Flannigan B, Gravesen S, Mouilleseaux A, et al. Biological particles in indoor environments. Indoor air quality and its impact on man Commission of European Communities, Brussels. 1993.
25. Administration) OOSaH. Indoor air quality-proposed rule. notice of proposed rulemaking. 1994;Regist. 59 (65): 15968-6039.
26. Canada) EE. Exposure Guidelines for Residential Indoor Air Quality,
. Environment Canada- Federal-Provincial Advisory Committee on Environmental and Occupational Health, Ottawa, Ontario. 1989;p. 23: (Online at: http://www.bvsde.paho.org/bvsacd/cd16/exposure.pdf).
27. Cho E-M, Hong HJ, Park SH, Yoon DK, Goung N, Ju S, et al. Distribution and influencing factors of airborne bacteria in public facilities used by pollution-sensitive population: a meta-analysis. International journal of environmental research and public health. 2019;16(9):1483.
28. Sudharsanam S, Srikanth P, Sheela M, Steinberg R. Study of the indoor air quality in hospitals in South Chennai, India—microbial profile. Indoor and Built Environment. 2008;17(5):435-41.
29. Commission E. Good manufacturing practices-medicinal products for human and veterinary use (the rules governing medicinal products in the European Union). Office for Official Publications of the European Communities. 2008.
30. Simoes SdAA, Júnior DPL, Hahn RC. Fungal microbiota in air-conditioning installed in both adult and neonatal intensive treatment units and their impact in two university hospitals of the central western region, Mato Grosso, Brazil. Mycopathologia. 2011;172(2):109-16.
31. Fekadu S, Getachewu B. Microbiological assessment of indoor air of Teaching hospital wards: a case of Jimma University specialized hospital. Ethiopian journal of health sciences. 2015;25(2):117-22.
32. Gilbert Y, Veillette M, Duchaine C. Airborne bacteria and antibiotic resistance genes in hospital rooms. Aerobiologia. 2010;26(3):185-94.
33. Li Y, Wang W, Guo X, Wang T, Fu H, Zhao Y, et al. Assessment of airborne bacteria and fungi in various university indoor environments: A case study in Chang'an University, China. Environmental Engineering Science. 2015;32(4):273-83.
34. Holton J, Ridgway GL, Reynoldson AJ. A microbiologist's view of commissioning operating theatres. Journal of Hospital Infection. 1990;16(1):29-34.
35. Tolabi Z, Alimohammadi M, Hassanvand MS, Nabizadeh R, Soleimani H, Zarei A. The investigation of type and concentration of bio-aerosols in the air of surgical rooms: A case study in Shariati hospital, Karaj. MethodsX. 2019;6:641-50.
36. Sudharsanam S, Swaminathan S, Ramalingam A, Thangavel G, Annamalai R, Steinberg R, et al. Characterization of indoor bioaerosols from a hospital ward in a tropical setting. African health sciences. 2012;12(2):217-25.
37. Viegas C, Rosado L. Assessment of fungal contamination in a Portuguese maternity unit. WIT Transactions on Biomedicine and Health. 2011;15:127-33.
38. Dehghani M, Sorooshian A, Nazmara S, Baghani AN, Delikhoon M. Concentration and type of bioaerosols before and after conventional disinfection and sterilization procedures inside hospital operating rooms. Ecotoxicology and environmental safety. 2018;164:277-82.
39. Augustowska M, Dutkiewicz J. Variability of airborne microflora in a hospital ward within a period of one year. Annals of Agricultural and Environmental Medicine. 2006;13(1):99-106.
40. Tormo-Molina R, Gonzalo-Garijo MA, Fernández-Rodríguez S, Silva-Palacios I. Monitoring the occurrence of indoor fungi in a hospital. Revista iberoamericana de micología. 2012;29(4):227-34.
IssueVol 5 No 4 (2020): Autumn 2020 QRcode
SectionOriginal Research
DOI https://doi.org/10.18502/japh.v5i4.6442
Indoor air quality; Bioaerosols; Bacterial air quality; Fungal air quality; Hospital wards; Urmia

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Gholampour A, Biglaric A, Barzeghar V, Zolfaghari Firouzsalari N. Assessment of airborne bacterial and fungal communities in different wards of educational hospitals: A case study in Urmia, Iran. japh. 2021;5(4):209-222.