Airborne microorganisms in hospitals have been associated with several hospital-acquired infections (HAIs), and various measures of indoor air quality (IAQ) parameters such as temperature, relative humidity, carbon dioxide (CO₂), particle mass concentration, and particle size have been linked to pathogen survival or mitigation of pathogen spread. To investigate whether there are quantitative relationships between the concentration of airborne microorganisms and the IAQ in the hospital environment. Web of Science, Scopus and PubMed databases were searched for studies reporting airborne microbial levels and any IAQ parameter(s) in hospital environments, from database inception to October 2020. Pooled effect estimates were determined via random-effects models. Seventeen of 654 studies were eligible for the meta-analysis. The concentration of airborne microbial measured as aerobic colony count (ACC) was significantly correlated with temperature (r = 0.25 [95% CI = 0.06–0.42], p = 0.01), CO₂ concentration (r = 0.53 [95% CI = 0.40–0.64], p ˂ 0.001), particle mass concentration (≤5 µg/m³; r = 0.40 [95% CI = 0.04–0.66], p = 0.03), and particle size (≤5 and ˃5 µm), (r = 0.51 [95% CI = 0.12–0.77], p = 0.01 and r = 0.55 [95% CI = 0.20–0.78], p = 0.003), respectively, while not being significantly correlated with relative humidity or particulate matter of size >5 µm. Conversely, airborne total fungi (TF) were not significantly correlated with temperature, relative humidity, or CO₂ level. However, there was a significant weak correlation between ACC and TF (r = 0.31 [95% CI = 0.07–0.52], p = 0.013). Although significant correlations exist between ACC and IAQ parameters, the relationship is not definitive; the IAQ parameters may affect the microorganisms but are not responsible for the presence of airborne microorganisms. Environmental parameters could be related to the generating source, survival, dispersion, and deposition rate of microorganisms. Future studies should record IAQ parameters and factors such as healthcare worker presence and the activities carried out such as cleaning, sanitizing, and disinfection protocols. Foot traffic would influence both the generation of microorganisms and their deposition rate onto surfaces in the hospital environment. These data would inform models to improve the understanding of the likely concentration of airborne microorganisms and provide an alternative approach for real-time monitoring of the healthcare environment.

中文翻译：

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室内空气质量参数与医院环境中空气传播的微生物之间有什么关系？系统评价和荟萃分析

医院中的空气传播微生物与几种医院获得性感染 (HAI) 以及室内空气质量 (IAQ) 参数的各种测量有关，例如温度、相对湿度、二氧化碳 (CO ₂)、颗粒质量浓度和颗粒大小与病原体存活或病原体传播的减缓有关。探讨空气微生物浓度与医院环境室内空气质量之间是否存在定量关系。在 Web of Science、Scopus 和 PubMed 数据库中搜索了报告空气微生物水平和医院环境中任何 IAQ 参数的研究，从数据库开始到 2020 年 10 月。汇总效应估计是通过随机效应模型确定的。654 项研究中有 17 项符合荟萃分析的条件。作为需氧菌落计数 (ACC) 测量的空气传播微生物浓度与温度显着相关 ( r  = 0.25 [95% CI = 0.06–0.42], p  = 0.01)、CO ₂浓度 ( r  = 0.53 [95% CI = 0.40–0.64], p  ˂ 0.001), 粒子质量浓度 (≤5 µg/m ³ ; r  = 0.40 [95% CI = 0.04–0.66], p  = 0.03), 和粒径（≤5 和˃5 µm），（r  = 0.51 [95% CI = 0.12–0.77]，p  = 0.01 和r  = 0.55 [95% CI = 0.20–0.78]，p  = 0.003），而与相对湿度或大于 5 µm 的颗粒物没有显着相关性。相反，空气传播的总真菌 (TF) 与温度、相对湿度或 CO ₂水平没有显着相关性。然而，ACC与TF之间存在显着的弱相关（r = 0.31 [95% CI = 0.07–0.52]，p = 0.013）。尽管 ACC 和 IAQ 参数之间存在显着的相关性，但这种关系并不是确定的；IAQ 参数可能会影响微生物，但与空气中微生物的存在无关。环境参数可能与微生物的产生源、存活、扩散和沉积速率有关。未来的研究应记录室内空气质量参数和因素，例如医护人员的存在以及所进行的活动，例如清洁、消毒和消毒协议。人流量会影响微生物的产生及其在医院环境中表面的沉积率。