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Detection of SARS-CoV-2 in aerosol and surface samples in high acuity hospital settings during community epidemic waves – implications for risk-based infection control
Journal article   Peer reviewed

Detection of SARS-CoV-2 in aerosol and surface samples in high acuity hospital settings during community epidemic waves – implications for risk-based infection control

C. Raina MacIntyre, Adriana Notaras, Noor Bari, Con Doolan, Mohamed Mahmoud Abdelkareem Mahmoud, Damian Honeyman, Andre Fellipe Vilanova de Araujo Aquino, Ian Seppelt, Mark Nicholls, Stuart Turville, …
Respiratory medicine, Vol.253, pp.1-9
03/2026
PMID: 41692075

Abstract

Aerosols Emergency units Infection control Intensive care units SARS-CoV-2
Rationale: Nosocomial transmission of SARS-CoV-2 is multifactorial and may vary between clinical sites. Objectives: To measure SARS-CoV-2 in the air and on surfaces within the Intensive Care Unit (ICU) and Emergency Department (ED). Methods: We conducted an air and surface-sampling study of SARS-CoV-2 in the ED and ICU of a hospital in Sydney. Measurements: We sampled air, patient equipment, and personal protective equipment during two community COVID-19 epidemics. SARS-CoV-2 was detected using quantitative reverse transcription polymerase chain reaction (RT-qPCR). Carbon dioxide (CO<sub>2</sub> was measured simultaneously, with <800 ppm indicating good air quality. Main results: SARS-CoV-2 genetic material was detected in 39% of 51 aerosol samples, with mean CO levels consistently <800 ppm for positive samples. The ED had more detections than the ICU (80% vs. 20%; p < 0.0027) and a higher mean CO level than the ICU (669 ppm vs. 522 ppm; p < 0.05). The ED waiting room, acute ward, and ICU staff tearoom showed higher detection rates than the ICU ward area. SARS-CoV-2 was detected in air samples in the ED a week before an outbreak was declared, and both inside and outside a COVID-19 patient's negative-pressure ICU room, where high-flow nasal prongs and a glove tested positive. Conclusion: During community epidemics, SARS-CoV-2 genetic material is detected in hospital air despite good ventilation. Enhanced protection with masks, vaccines, and portable air purifiers, especially in high-risk areas, may mitigate nosocomial transmission, including among staff. Air sampling can provide an early warning of an outbreak and help identify areas that need enhanced infection control.

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