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Micrococci and staphylococci are commonly isolated when bacteriologic samples of room air are taken; however, their role as pathogens via the airborne route has not been established. Inhalation anthrax is the only well documented Gram positive lower respiratory infection that can follow airborne challenge. Pulmonary anthrax is now rare but at one time was an important hazard for textile workers exposed to goat hair imported from the Middle East. Aerosol challenge studies in experimental animals using anthrax spores have shown that particle size and total inoculum are important predictors of disease. Air sampling studies in goat hair processing plants showed that workers were regularly exposed to low levels of airborne anthrax but few cases occurred. The disease has all but disappeared, with the last United States case reported in 1977. There are no persuasive data suggesting that other airborne Gram positives are important pathogens and routine aerosol sampling for their presence is not recommended.
inhalation anthrax, air sampling, goat hair, aerosol challenges, Woolsorters' Disease
ChairmanProfessor of Medicine, The Genesee HospitalUniversity of Rochester School of Medicine and Dentistry, Rochester, NY