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 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/m) than private-style NICU (151.94-466.43), indicating a possible threat to health. In the public-style NICU, was the highest bacterial genera identified in the present study, were and predominated, especially in the second bronchi and alveoli size ranges. , , , , and , were identified in the alveoli size range. In NICU#2, eight species were identified in the alveoli size range: , , , , , , , and Multi-drug-resistant organisms (MDROs) were found in both of the NICUs. strains were resistant to Ampicillin, Cefoxitin, Ceftaroline, and Penicillin G. ssp. was resistant in parallel to ampicillin and G penicillin. 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.