幼兒園室內生物氣膠抗藥性採樣評估-以冬春季採樣為例

Sampling Evaluation of Bioaerosol and Antibiotic-resistant - Sampling in Winter and Spring

許芷瑜(Tzu-Yu Hsu)

指導教授 ： 賴全裕

中山醫學大學/健康管理學院/職業安全衛生學系碩士班/碩士(2018年)

摘要

近年來人類在室內所花費的時間越來越多，而學齡前兒童是最容易受到空氣污染物影響的群體之一，因此本研究於三間中部幼兒園採集室內空氣中細菌及真菌樣本，目的為1.瞭解兒童及幼教人員暴露生物氣膠之濃度及其粒徑分布特性2.瞭解幼兒園室內空氣中細菌種類及其抗藥性特性。

本研究於2018年1月(冬)、4月(春)、5月(春)及6月(春)以安德森六階式採樣器搭配胰蛋白酶大豆瓊脂與麥芽萃取物瓊脂，分別採集細菌及真菌樣本。以攝氏37度培養後之細菌樣本，接著進行分離、革蘭氏染色、菌種鑑定及抗藥性分析。真菌樣本以攝氏25度培養後，經專業醫檢人員進行菌屬鑑定。

結果顯示，三間幼兒園所採集之生物氣膠分佈以截取粒徑3.3 µm以下為主(59% ~ 77%)，而多重抗藥性細菌在三間幼兒園之可呼吸性粉塵(<3.3 µm)中比例為4.05% ~ 6.19%，此粒徑範圍之生物氣膠極有可能進到人體肺泡區，造成伺機性感染。菌種鑑定方面，細菌以革蘭氏陽性菌為主(89.47% ~ 96.16%)，優勢菌為Micrococcus spp.、Staphylococcus spp.、Bacillus spp.及Corynebacterium spp.，真菌優勢菌群為Cladosporium spp.及Penicillium spp.。微生物危險群等級(Risk Group, RG)，革蘭氏陽性菌以RG1的比例較RG2高；革蘭氏陰性菌菌種以RG2比例較RG1高，且幾乎未採集到RG1等級之菌種。抗藥性分析以採集到之Staphylococcus spp.有較廣泛的抗藥性，共對12種類型抗生素具有抗藥性，其中於Ampicillin、Erythromycin、Penicillin G、Oxacillin這四種抗生素之抗藥性比例較高。

綜合以上結果，本研究採集之生物氣膠其微生物多以環境菌為主，但仍然有BODE SCIENCE CENTER臨床相關病原體資料庫中所列及之致病菌，而這些機緣性致病菌於免疫力低下或對於呼吸道疾病有較大易感性之兒童，可能會造成不良的健康影響。

關鍵字

生物氣膠 ； 安德森六階採樣器 ； 幼兒園 ； 抗生素

並列摘要

Recently people stay indoor longer and longer. The preschool children are one of groups being easily susceptible to pollutant in the air. Therefore this research takes bacteria and fungi sample in the indoor air at three nursery schools from the middle of Taiwan. The purpose is 1. To understand the concentration of bioaerosol and the distributional characteristics of particle size exposed to children and their teachers. 2. To understand the bacterial species and the characteristics of antibiotic resistance in the air of nursery school.

This research respectively takes the bacteria and fungi samples by Andersen six-stage sampler associated with tryptone soy agar and malt extract agar. Then we incubate those bacteria samples at 37 degree celsius, do sample separation, gram staining, bacterium identification, and analysis of antibiotic resistance.

The result shows that the major part of the bioaerosol taken from those three nursery schools are below cut off size of 3.3 µm. The ratio of bacteria with multiple drug resistance among the respiratory dust (<3.3 µm)from those three nursery schools is 4.05%~6.19%. It is highly possible that the bioaerosol with this range of particle size could enter human alveoli to cause the potential infection. Regarding to the bacteria identification, the major bacteria is gram positive(89.47% ~ 96.16%). The dominant bacteria are Micrococcus spp.、Staphylococcus spp.、Bacillus spp. and Corynebacterium spp. The dominant fungi are Cladosporium spp. and Penicillium spp. Regarding to the risk group(RG), the ratio of RG1 is higher than RG2 in the Gram-positive bacteria. The ratio of RG2 is higher than RG1 in the Gram-negative bacteria and we hardly collect the bacteria in the RG1 class. Regarding to the analysis of antibiotic resistance, Staphylococcus spp. has wider range of the antibiotic resistance. It has antibiotic resistance and is insusceptible to 12 types of antibiotics. Among them the ratio of antibiotic resistance is high to these four antibiotics such as Ampicillin、Erythromycin、Penicillin G、Oxacillin.

All the results above show that the major microorganism in the bioaerosol collected in this research is environmental bacteria. It still has some pathogenic bacteria registered in the data bank of clinical bacterium in BODE SCIENCE Center. Those opportunistic pathogenic bacteria could cause disease among the children with low immunity and respiratory disease.

並列關鍵字

bioaerosol ； Anderson six-stage sampler ； nursery school ； antibiotic

參考文獻

Aydogdu, H., Asan, A., & Tatman Otkun, M., Indoor and

outdoor airborne bacteria in child day-care centers in

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