Healthcare-associated infections remain a major cause of morbidity, mortality, and financial burden worldwide, further exacerbated by the emergence of antimicrobial resistance. Environmental reservoirs of pathogens, including air and surfaces, play a critical role in nosocomial transmission. This study by Martínez-Murcia, et al. (2026) aimed to validate an integrated air and surface molecular surveillance system for the early detection of clinically relevant pathogens and resistance genes in hospital environments.
Weekly air and surface samples were collected over 28 weeks from two hospitals in southeastern Spain. DNA and RNA were extracted and analyzed by quantitative PCR (qPCR) targeting bacterial, fungal, and viral pathogens, as well as antimicrobial resistance genes. A subset of samples underwent shotgun metagenomic sequencing to confirm qPCR results and characterize microbial communities. Environmental findings were compared with clinical infection data from both hospitals.
Viral, bacterial and fungal pathogens were detected with similar patterns between air and surface samples and between hospitals. Carbapenem resistance genes showed distinct distribution profiles between hospitals. Respiratory viruses displayed strong temporal correlations with patient admissions, with viral RNA occasionally detected before clinical peaks.
This integrated molecular surveillance system allows sensitive detection of pathogens and resistance genes in hospital environments. Coupling air and surface sampling with qPCR provides a robust tool for identifying contamination sources and tracking temporal infection trends. Its scalability and adaptability make it suitable for implementation as an early warning system in infection prevention programs, enhancing patient safety and supporting proactive control of nosocomial infections.
Martínez-Murcia, A., Navarro, A., Miró-Pina, C. et al. Early detection of nosocomial pathogens in air and surfaces using an innovative genetic approach for surveillance in healthcare settings. Antimicrob Resist Infect Control (2026). https://doi.org/10.1186/s13756-026-01725-8