存在醫院空氣中的生物氣膠主要來自院內活動之人們，醫護人員在診療病患過程中可能造成該區域生物氣膠濃度瞬間上昇，這些生物氣膠是否會傷害到醫護人員或隨院內之空調系統散播至它處，值得瞭解與探討。因此本研究採集台中地區三家醫院呼吸照護病房中之生物氣膠，以獲悉該環境之細菌與真菌的種類與數量，初步瞭解該些微生物是否會對醫護人員造成傷害。結果顯示醫院A呼吸照護病房中地點A-E(A地點位於洗澡間；B地點位於陽台；C地點位於辦公室；D及E地點位於病床區)之細菌與真菌平均濃度(cfu/m3)分別為1096±1105、880±802、788±1149、671±762、528±456及395±256、547±427、418±384、307±218、291±232。醫院B呼吸照護病房中地點A-E之細菌與真菌平均濃度(cfu/m3)分別為525±380、260±191、561±256、631±320、583±593及336±341、284±135、229±183、226±163、253±183。醫院C呼吸照護病房中地點A-E之細菌與真菌平均濃度(cfu/m3)分別為872±496、792±404、313±169、277±180、498±232及485±266、789±373、320±195、292±168、274±112。經菌種鑑定三家醫院存在較多細菌種類為Staphylococcus sp.、Bacillus sp.、Mycobacterium sp.與Dermacoccus sp.；較多真菌種類為Aspergillus sp.、Yarrowia sp.、Penicillium sp.及Paecilomyces sp.。此外，三家醫院利用五種採樣粒徑採集之不同大小生物氣膠中，以4.7-7.0m培養出來之細菌數量較多；真菌則以2.1-7.0m培養出來的數量較多。

Bioaerosols existing in the hospital come from the person's body. When the people stay a long time at the side of the patient that has the respiratory disease, the influence of the people's health are to be worth understanding. Therefore, the purpose of this study attempted to understand the concentration and types of the airborne microorganism at respiratory care ward in three hospitals of Taichung region. Besides, the aim is to understand the health effect of the people that stay a long time at the side of the patient with the bacteria and fungi concentrations. The results are: The total average bacteria and fungi concentration were 1096±1105, 880±802, 788±1149, 671±762, 528±456 and 395±256, 547±427, 418±384, 307±218, 291±232 cfu/m3 at sampling sites of A-E (A: washroom; B: balcony; C: office; D and E: sickbed) in the respiratory care ward of hospital A. The total average bacteria and fungi concentration were 525±380, 260±191, 561±256, 631±320, 583±593 and 336±341, 284±135, 229±183, 226±163, 253±183 cfu/m3 at sampling sites of A-E in the respiratory care ward of hospital B. The total average bacteria and fungi concentration were 872±496, 792±404, 313±169, 277±180, 498±232 and 485±266, 789±373, 320±195, 292±168, 274±112 cfu/m3 at sampling sites of A-E in the respiratory care ward of hospital C. The dominant bacteria and fungi types at respiratory care ward of three hospitals were Staphylococcus sp., Bacillus sp., Mycobacterium sp., Dermacoccus sp. and Aspergillus sp., Yarrowia sp., Penicillium sp., Paecilomyces sp. The particle sizes of 4.7-7.0 m and 2.1-7.0 m have the largest bacteria and fungi number at three hospitals.

中文摘要................................................................................................ Ⅰ
英文摘要................................................................................................ Ⅱ
目 錄.................................................................................................... Ⅲ
表 目 錄…………………………………………………………….. Ⅶ
圖 目 錄…………………………………………………………….. Ⅸ
第一章 緒論..................................................................................... 1
1-1 前言..................................................................................... 1
1-2 研究目的............................................................................. 2
第二章 文獻回顧……………………………………………….. 3
2-1 生物氣膠之基本特性…………………………………... 3
2-1-1 細菌特性…………………………………………... 4
2-1-2 真菌特性…………………………………………… 6
2-2 環境因子…………………………………………... 7
2-2-1 溫度………………………………………………… 7
2-2-2 相對溼度………………………………………....... 8
2-2-3 二氧化碳 (CO2)……………………………........... 8
2-3 生物氣膠對人體健康危害……………………….. 9
2-4 室內生物氣膠之粒徑分佈…………………………… 11
2-5 室內生物氣膠規範值………………………………………. 12
2-6 國內外學者對室內生物氣膠之相關研究............................. 13
第三章 實驗設備與方法……………………………………….. 18
3-1 採樣地點……………………………………………………. 18
3-1-1 A醫院…………………………………………………... 19
3-1-2 B醫院…………………………………………………... 23
3-1-3 C醫院…………………………………………………... 27
3-2 採樣時間…………………………………………………… 30
3-3 採樣高度…………………………………………………… 30
3-4 儀器及藥品………………………………………………… 31
3-4-1安德森六階生物氣膠採樣器………………………….. 31
3-4-2 溫濕度計………………………………………………. 32
3-4-3 CO2偵測器……………………………………………... 33
3-4-4 培養基…………………………………………………. 33
3-5 採樣流程…………………………………………………… 34
3-6 資料分析………………………………………………….... 35
3-6-1微生物平均濃度……………………………………….. 35
3-6-2菌種鑑定……………………………………………….. 35
3-7資料管理與統計分析……………………………………. 36
第四章 結果與討論……………………………………………. 37
4-1室內環境測量………………………………………………. 37
4-1-1溫度與相對溼度……………………………………….. 37
4-1-2二氧化碳濃度………………………………………….. 39
4-2生物氣膠濃度分佈………………………………………….. 40
4-2-1 A醫院…………………………………………………... 40
4-2-2 B醫院…………………………………………………... 45
4-2-3 C醫院…………………………………………………... 50
4- 3室內/室外值(I/O) ………………………………................... 56
4-4 菌種鑑定及分佈……………………………………............. 58
4-4-1 A醫院……………………………………………….. 58
4-4-2 B醫院……………………………………………….. 61
4-4-3 C醫院……………………………………………….. 64
4-5 粒徑分析…………………………………………………. 69
4-6 統計分析…………………………………………………. 74
4-6-1三間醫院中微生物濃度與環境因子的關係……….. .. 74
4-6-1-1 A醫院………………………………………………………… 74
4-6-1-2 B醫院…………………………………………. 76
4-6-1-3 C醫院................................................................. 77
4-6-2三間醫院環境因素與微生物組成分分析………… 79
4-6-2-1 A醫院……………………………………………………….. 79
4-6-2-2 B醫院………………………………………. 81
4-6-2-3 C醫院............................................................... 83
4-6-3 三間醫院秋冬兩季對細、真菌之差異…………… 87
4-6-3-1 A醫院………………………………………………………… 87
4-6-3-2 B醫院………………………………………. 89
4-6-3-3 C醫院............................................................... 91
第五章 結論與建議........................................................... 93
5-1 結論………………………………………………………… 93
5-2 建議……………………………………………………… 96
參考文獻………………………………………………………… 97
英文文獻…………………………………………………. 97
中文文獻…………………………………………………. 100

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