Pena, PedroCervantes, RenataViegas, Carla2025-09-042025-09-042025-06Pena P, Cervantes R, Viegas C. MRSA environmental surveillance: the need for standardized protocols. In: AIRMON 2025 – 11th International Symposium on Modern Principles for Air Monitoring and Biomonitoring, Loen (Norway), June 15-19, 2025.http://hdl.handle.net/10400.21/22113H&TRC authors gratefully acknowledge FCT/MCTES UIDP/05608/2020, and UIDB/05608/2020. This work is also supported by national funds through FCT/MCTES/FSE/UE, 2023.01366.BD; UI/BD/153746/2022 and CE3C unit UIDB/00329/2020; UI/BD/151431/2021; and Instituto Politécnico de Lisboa, national support through IPL/2022/InChildhealth/BI/12M; and for funding the projects IPL/IDI&CA2024/WWTPSValor_ESTeSL and IPL/IDI&CA2024/MycoSOS_ESTeSL, and the Academy of Medical Sciences (SBF007/100130). InChildHealth is funded by the European Union (Grant Agreement No. 101056883) via the European Health and Digital Executive Agency (HaDEA). Additional funding is provided by the Swiss State Secretariat for Education, Research and Innovation (SERI; Grant 22.00324), UK Research and Innovation (UKRI; Grant 10040524), and the Australian National Health & Medical Research Council (NHMRC; Grants APP2017786 and APP2008813). The views expressed are those of the authors and do not necessarily reflect those of HaDEA, the EU, or any funding agency.Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of infections, with airborne transmission playing a crucial role in its environmental spread. While healthcare settings remain high-risk areas, the increasing presence of community-associated MRSA (CA-MRSA) and livestock-associated MRSA (LA-MRSA) in diverse environments raises new public health concerns. This systematic review assessed MRSA contamination in different environmental reservoirs, focusing on transmission pathways and sampling methodologies. A literature search was conducted using databases such as PubMed, Scopus, and Web of Science, identifying 95 studies that reported MRSA detection through environmental sampling. MRSA was detected in healthcare settings (N=19), aquatic environments (N=13), wastewater treatment plants (N=5), public and occupational settings (N=11), and farms/veterinary hospitals (N=27). The growing presence in public and agricultural environments highlights the need for broader surveillance beyond hospitals. A review of sampling methods showed substantial variability. Active air sampling (27 studies, 28%) included impaction, filtration, and impinger techniques with diverse culture media and filter types. Passive sampling (84 studies, 88%) was more common, using settled dust, electrostatic dust cloths, settle plates, dust wipes, and swabs. The lack of standardized protocols complicates data comparability and limits risk assessment accuracy. The widespread detection of MRSA across environments underscores the importance of airborne transmission. While healthcare settings remain hotspots, increasing contamination in public and agricultural areas demands harmonized surveillance protocols. Standardizing air sampling techniques, culture media, and resistance profiling is essential for effective monitoring. A One Health approach integrating human, animal, and environmental interactions is crucial to mitigating airborne MRSA transmission and antimicrobial resistance risks. Future research should prioritize standardized methodologies to enhance global monitoring and control efforts.engEnvironmental healthMethicillin-resistant Staphylococcus aureusMRSAFCT_UIDP/05608/2020FCT_UIDB/05608/2020IPL/2022/InChildhealth/BI/12MIPL/IDI&CA2024/WWTPSValor_ESTeSLIPL/IDI&CA2024/MycoSOS_ESTeSLconference poster