{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:47:02Z","timestamp":1785422822479,"version":"3.56.0"},"reference-count":32,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fondo Universitario per la Ricerca"},{"DOI":"10.13039\/501100007052","name":"University of Verona","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007052","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/039bp8j42","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Department of Engineering for Innovation Medicine"},{"name":"Department of Neurosciences, Biomedicine and Movement Sciences"},{"name":"Ministry of Health","award":["L3P6"],"award-info":[{"award-number":["L3P6"]}]},{"award":["L3P6"],"award-info":[{"award-number":["L3P6"]}],"id":[{"id":"https:\/\/ror.org\/00789fa95","id-type":"ROR","asserted-by":"publisher"}]},{"name":"EASYLINKED S.r.l."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>In this exploratory pilot study, quantitative analyses were performed on seven leather wheelchairs and the protective barrier was evaluated on three leather wheelchairs, while shotgun metagenomic sequencing (Illumina and Oxford Nanopore) was conducted on pooled samples obtained from seven leather and three fabric wheelchairs to characterize microbial DNA recovered from wheelchair surfaces under routine clinical conditions. Microbial DNA and biomass were detected on all sampled surfaces, with median DNA concentrations of approximately 0.015 ng\/\u00b5L, median cell counts of approximately 4.8 \u00d7 105 cells\/mL, and median OD600 values of approximately 0.038, although variability among wheelchairs was observed. NGS analysis revealed heterogeneous microbial communities composed mainly of taxa associated with human skin microbiota and environmental sources. Opportunistic taxa including Escherichia coli, Staphylococcus haemolyticus, Achromobacter xylosoxidans, and Clostridioides difficile DNA were detected. Differences in microbial composition were observed between the pooled fabric and leather samples, with fabric samples characterized by the dominance of specific taxa and leather samples exhibiting a more heterogeneous microbial profile. In addition, median DNA concentration, cell counts, and OD600 values were reduced by approximately 98\u2013100% on the protective barrier compared with uncovered wheelchair surfaces, with statistically significant differences between conditions. Overall, these findings suggest that hospital wheelchairs may harbor measurable levels of microbial biomass and microbial DNA despite routine sanitation procedures. Lower contamination levels were observed on the protective barrier under the conditions tested. Due to the exploratory nature of the study, the small sample size, and the use of pooled samples for metagenomic analyses, these observations should be interpreted with caution and require confirmation in larger studies.<\/jats:p>","DOI":"10.3390\/pathogens15070693","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:50:37Z","timestamp":1782867037000},"page":"693","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High-Touch, High-Risk: An Exploratory Microbiome Analysis of Hospital Wheelchairs"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3263-6671","authenticated-orcid":false,"given":"Luca","family":"Dalle Carbonare","sequence":"first","affiliation":[{"name":"Department of Engineering for the Innovation Medicine, University of Verona, 37100 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Vareschi","sequence":"additional","affiliation":[{"name":"Department of Engineering for the Innovation Medicine, University of Verona, 37100 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Dervishi","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37100 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7595-2346","authenticated-orcid":false,"given":"Michela","family":"Deiana","sequence":"additional","affiliation":[{"name":"Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar di Valpolicella, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8682-7089","authenticated-orcid":false,"given":"Elena","family":"Locatelli","sequence":"additional","affiliation":[{"name":"Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar di Valpolicella, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4610-1168","authenticated-orcid":false,"given":"Arianna","family":"Minoia","sequence":"additional","affiliation":[{"name":"Department of Engineering for the Innovation Medicine, University of Verona, 37100 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2096-9441","authenticated-orcid":false,"given":"Francesca Cristiana","family":"Piritore","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37100 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Ruggiero","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37100 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilda Czobor","family":"Barbu","sequence":"additional","affiliation":[{"name":"Department of Botany and Microbiology, Faculty of Biology, University of Bucharest, 030018 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2168-4144","authenticated-orcid":false,"given":"Donato","family":"Zipeto","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37100 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5739-3795","authenticated-orcid":false,"given":"Chiara","family":"Piubelli","sequence":"additional","affiliation":[{"name":"Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar di Valpolicella, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1166-8033","authenticated-orcid":false,"given":"Maria Teresa","family":"Valenti","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37100 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.14715\/cmb\/2025.71.10.2","article-title":"Healthcare-associated infections: An overview of global strategies and challenges in minimizing infection transmission","volume":"71","author":"Abalkhail","year":"2025","journal-title":"Cell. Mol. Biol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e20561","DOI":"10.1016\/j.heliyon.2023.e20561","article-title":"The burden of hospital acquired infections and antimicrobial resistance","volume":"9","author":"Abban","year":"2023","journal-title":"Heliyon"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s11908-018-0620-2","article-title":"The role of environmental contamination in the transmission of nosocomial pathogens and healthcare-associated infections","volume":"20","author":"Suleyman","year":"2018","journal-title":"Curr. Infect. Dis. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1017\/S0950268816002193","article-title":"Mechanisms for floor surfaces or environmental ground contamination to cause human infection: A systematic review","volume":"145","author":"Rashid","year":"2017","journal-title":"Epidemiol. Infect."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"11786302251328550","DOI":"10.1177\/11786302251328550","article-title":"Microbial contamination of door handles: A global systematic review and meta-analysis of public and healthcare settings","volume":"19","author":"Appiah","year":"2025","journal-title":"Environ. Health Insights"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.ajic.2023.11.006","article-title":"Understanding the significance of microbiota recovered from health care surfaces","volume":"52","author":"Jinadatha","year":"2024","journal-title":"Am. J. Infect. Control"},{"key":"ref_7","unstructured":"Ondiege, J., Tenambergen, W., and Oluoch, M. (2024). Assessing the influence of built environment factors on the accessibility of hospital facilities for wheelchair users: A comprehensive analysis. Acad. J. Health Syst. Reforms, 11."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1108\/SASBE-01-2024-0035","article-title":"Public toilets for accessible and inclusive cities: Disability, design and maintenance from the perspective of wheelchair users","volume":"14","author":"Carnemolla","year":"2025","journal-title":"Smart Sustain. Built Environ."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Chawla, H., Anand, P., Garg, K., Bhagat, N., Varmani, S.G., Bansal, T., McBain, A.J., and Marwah, R.G. (2023). A comprehensive review of microbial contamination in the indoor environment: Sources, sampling, health risks, and mitigation strategies. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1285393"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Tozzo, P., Delicati, A., and Caenazzo, L. (2022). Human microbiome and microbiota identification for preventing and controlling healthcare-associated infections: A systematic review. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.989496"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1038\/s41370-019-0157-y","article-title":"Building upon current knowledge and techniques of indoor microbiology to construct the next era of theory into microorganisms, health, and the built environment","volume":"30","author":"Horve","year":"2020","journal-title":"J. Expo. Sci. Environ. Epidemiol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Comar, M., D\u2019accolti, M., Cason, C., Soffritti, I., Campisciano, G., Lanzoni, L., Bisi, M., Volta, A., Mazzacane, S., and Caselli, E. (2019). Introduction of NGS in environmental surveillance for healthcare-associated infection control. Microorganisms, 7.","DOI":"10.3390\/microorganisms7120708"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Cason, C., D\u2019Accolti, M., Soffritti, I., Mazzacane, S., Comar, M., and Caselli, E. (2022). Next-generation sequencing and PCR technologies in monitoring the hospital microbiome and its drug resistance. Front. Microbiol., 13.","DOI":"10.3389\/fmicb.2022.969863"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1177\/1535370218821857","article-title":"Uncovering the hidden microbiota in hospital and built environments: New approaches and solutions","volume":"244","author":"Christoff","year":"2019","journal-title":"Exp. Biol. Med."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Vareschi, A., Gaglio, S.C., Dervishi, K., Minoia, A., Zanella, G., Lucchi, L., Serena, E., Jimenez-Lopez, C., Piritore, F.C., and Meneghel, M. (2025). Evaluation of biocontrol measures to reduce bacterial load and healthcare-associated infections. Microorganisms, 13.","DOI":"10.3390\/microorganisms13081923"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"giaa111","DOI":"10.1093\/gigascience\/giaa111","article-title":"IDseq\u2014An open source cloud-based pipeline and analysis service for metagenomic pathogen detection and monitoring","volume":"9","author":"Kalantar","year":"2020","journal-title":"Gigascience"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1086\/424667","article-title":"Contamination, disinfection, and cross-colonization: Are hospital surfaces reservoirs for nosocomial infection?","volume":"39","author":"Weinstein","year":"2004","journal-title":"Clin. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1007\/s11908-018-0648-3","article-title":"Sink-related outbreaks and mitigation strategies in healthcare facilities","volume":"20","author":"Parkes","year":"2018","journal-title":"Curr. Infect. Dis. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.36740\/WLek\/205362","article-title":"Microbiological monitoring of the hospital environment: Risk assessment and strategies in infection control systems","volume":"2025","author":"Zublenko","year":"2005","journal-title":"Wiadomo\u015bci Lek."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1080\/14760584.2018.1488590","article-title":"Escherichia coli and Staphylococcus aureus: Leading bacterial pathogens of healthcare associated infections and bacteremia in older-age populations","volume":"17","author":"Poolman","year":"2018","journal-title":"Expert Rev. Vaccines"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Lautenbach, E., and Abrutyn, E. (2009). Healthcare-acquired bacterial infections. Bacterial Infections of Humans: Epidemiology and Control, Springer.","DOI":"10.1007\/978-0-387-09843-2_26"},{"key":"ref_22","unstructured":"Chowdhury, M.A.J.H. (2016). Risk Factors of Hospital Acquired Infections Among Patients Admitted in A Selected Hospital in Dhaka. [Ph.D. Thesis, University of Rajshahi]."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1080\/14787210.2020.1730813","article-title":"Emergence of coagulase-negative staphylococci","volume":"18","author":"Becker","year":"2020","journal-title":"Expert Rev. Anti-Infect. Ther."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Eltwisy, H.O., Twisy, H.O., Hafez, M.H., Sayed, I.M., and El-Mokhtar, M.A. (2022). Clinical infections, antibiotic resistance, and pathogenesis of Staphylococcus haemolyticus. Microorganisms, 10.","DOI":"10.3390\/microorganisms10061130"},{"key":"ref_25","first-page":"119","article-title":"Significance of Staphylococcus haemolyticus in hospital acquired infections","volume":"4","author":"Daniel","year":"2014","journal-title":"J. Pioneer. Med. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"127652","DOI":"10.1016\/j.micres.2024.127652","article-title":"Staphylococcus haemolyticus: An updated review on nosocomial infections, antimicrobial resistance, virulence, genetic traits, and strategies for combating this emerging opportunistic pathogen","volume":"282","author":"Rossi","year":"2024","journal-title":"Microbiol. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1007\/s11033-025-10773-z","article-title":"A narrative overview of Staphylococcus haemolyticus: Resistance traits, virulence factors, and health impact","volume":"52","author":"Meenatchi","year":"2025","journal-title":"Mol. Biol. Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1093\/clinids\/23.3.569","article-title":"Achromobacter xylosoxidans bacteremia: Report of four cases and review of the literature","volume":"23","author":"Duggan","year":"1996","journal-title":"Clin. Infect. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1155\/2015\/973284","article-title":"Delftia acidovorans: A rare pathogen in immunocompetent and immunocompromised patients","volume":"26","author":"Bilgin","year":"2015","journal-title":"Can. J. Infect. Dis. Med. Microbiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e0032622","DOI":"10.1128\/spectrum.00326-22","article-title":"Characteristics and outcomes of patients with Delftia acidovorans infections: A retrospective cohort study","volume":"10","author":"Rezahosseini","year":"2022","journal-title":"Microbiol. Spectr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1128\/CMR.00044-14","article-title":"Microbiology, genomics, and clinical significance of the Pseudomonas fluorescens species complex, an unappreciated colonizer of humans","volume":"27","author":"Scales","year":"2014","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Silverio, M.P., Kraychete, G.B., Rosado, A.S., and Bonelli, R.R. (2022). Pseudomonas fluorescens complex and its intrinsic, adaptive, and acquired antimicrobial resistance mechanisms in pristine and human-impacted sites. Antibiotics, 11.","DOI":"10.3390\/antibiotics11080985"}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/15\/7\/693\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T04:23:48Z","timestamp":1783657428000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/15\/7\/693"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":32,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["pathogens15070693"],"URL":"https:\/\/doi.org\/10.3390\/pathogens15070693","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]}}}