Antibiotic resistance of bioaerosols in particulate matter from indoor environments of the hospitals in Dhaka Bangladesh

Abstract

Abstract The emergence and spread of antibiotic resistance in microorganisms pose significant challenges to public health, especially in hospitals. This study investigated the existence or occurrence of bacterial bioaerosol and their antibiotic resistance patterns in particulate matter (PM) collected from hospitals in the greater Dhaka region, Bangladesh. The real-time particulate matter concentrations (PM1.0, PM2.5, and PM10) were measured in four hospitals and two ambient locations. Air sampling was conducted using a filter-based method with a low-volume air sampler, while AEROCET-531 S (USA) was employed to monitor particulate matter concentrations. Bacterial bioaerosol concentration was determined using a culture-based method, and eleven bacterial species, including nine individual species, i.e., Staphylococcus aureus, Pseudomonas aeruginosa, P. stutzeri, Bacillus cereus, Acinetobacter schindleri, Proteus vulgaris, B. subtilis, Escherichia coli, and B. aerius, were isolated. Antibiotic susceptibility testing was conducted using the Kirby-Bauer disk diffusion method with 21 antibiotics. Bacterial isolates were detected using partial sequencing of the 16 S rRNA gene. Bioaerosol concentration ranged from 194.65 ± 22.48 CFU/m3 to 948.39 ± 84.14 CFU/m3, showing significant correlations with PM1.0 and PM2.5 concentrations (R2 = 0.80 and 0.85, respectively). All bacterial isolates collected from the hospitals exhibited resistance against four or more antibiotics, indicating multidrug resistance (MDR). Notably, the bacterial isolates displayed the highest resistance rate against ampicillin (90.90%), azithromycin (81.81%), erythromycin (81.81%), cefixime (81.81%), and cotrimoxazole (54.54%), among the tested antibiotics. Except B. aerius, all other bacterial isolates were associated with hospital-acquired infections (HAIs). These findings highlight the high rates of antibiotic resistance, underscoring the pressing requirement for infection control measures and continuous surveillance strategies in hospital settings. These findings emphasize the necessity for global hospital infection control strategies focusing airborne multidrug-resistant microorganisms.

Keywords

• Bioaerosols
• Particulate matter
• Antibiotic resistance
• Hospital-acquired infections
• Nosocomial infections
• Air Quality