High Sensitivity of Children to Swimming-Associated Gastrointestinal Illness

Wade, Timothy J.; Calderon, Rebecca L.; Brenner, Kristen P.; Sams, Elizabeth; Beach, Michael J.; Haugland, Richard A.; Wymer, Larry; Dufour, Alfred

doi:10.1097/ede.0b013e318169cc87

Cited by 254 publications

(227 citation statements)

References 25 publications

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“…In addition, the designed primerprobe set for ENT has high specificity for Enterococcus faecium and Enterococcus faecalis, which are abundant in animal gastrointestinal tracts, whereas the culture-based method is less specific and may grow nonenteric species that occur naturally in the environment, such as Enterococcus casseliflavus (37). Studies have also suggested that qPCR results are more capable of predicting gastrointestinal illness than culture-based results (38).…”

Section: Discussionmentioning

confidence: 99%

Alternative Fecal Indicators and Their Empirical Relationships with Enteric Viruses, Salmonella enterica, and Pseudomonas aeruginosa in Surface Waters of a Tropical Urban Catchment

Liang

Goh

Vergara

et al. 2015

Appl Environ Microbiol

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The suitability of traditional microbial indicators (i.e., Escherichia coli and enterococci) has been challenged due to the lack of correlation with pathogens and evidence of possible regrowth in the natural environment. In this study, the relationships between alternative microbial indicators of potential human fecal contamination (Bacteroides thetaiotaomicron, Methanobrevibacter smithii, human polyomaviruses [HPyVs], and F؉ and somatic coliphages) and pathogens (Salmonella spp., Pseudomonas aeruginosa, rotavirus, astrovirus, norovirus GI, norovirus GII, and adenovirus) were compared with those of traditional microbial indicators, as well as environmental parameters (temperature, conductivity, salinity, pH, dissolved oxygen, total organic carbon, total suspended solids, turbidity, total nitrogen, and total phosphorus). Water samples were collected from surface waters of urban catchments in Singapore. Salmonella and P. aeruginosa had significant positive correlations with most of the microbial indicators, especially E. coli and enterococci. Norovirus GII showed moderately strong positive correlations with most of the microbial indicators, except for HPyVs and coliphages. In general, high geometric means and significant correlations between human-specific markers and pathogens suggest the possibility of sewage contamination in some areas. The simultaneous detection of human-specific markers (i.e., B. thetaiotaomicron, M. smithii, and HPyVs) with E. coli and enterococcus supports the likelihood of recent fecal contamination, since the human-specific markers are unable to regrow in natural surface waters. Multiple-linear-regression results further confirm that the inclusion of M. smithii and HPyVs, together with traditional indicators, would better predict the occurrence of pathogens. Further study is needed to determine the applicability of such models to different geographical locations and environmental conditions. Indicator bacteria, such as Escherichia coli and enterococci (ENT), have been used extensively in past decades to indicate the presence of human enteric pathogens because of the great diversity of pathogens, the large volumes required, and the difficulty in concentrating the typically low concentrations of pathogens from water samples. In Singapore, microbial water quality guidelines for recreational freshwater currently target enterococci (less than 200 counts per 100 ml for 95% of the time).Despite the wide use of fecal indicator bacteria in microbial water quality monitoring, their suitability to represent a level of health risk is still being questioned. One of the reasons is the lack of data correlating the presence and concentrations of the indicators with the presence of disease-associated pathogens. With improvements in microbiological test methods and bacterial species identification, there is growing evidence that fecal indicator bacteria, including E. coli and ENT, do not necessarily correlate well with some of the enteric pathogens, particularly viruses (1). There is also evidence that E. ...

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Section: Discussionmentioning

confidence: 99%

Alternative Fecal Indicators and Their Empirical Relationships with Enteric Viruses, Salmonella enterica, and Pseudomonas aeruginosa in Surface Waters of a Tropical Urban Catchment

Liang

Goh

Vergara

et al. 2015

Appl Environ Microbiol

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“…Escherichia coli (E. coli), enterococci, Campylobacter, Salmonella) indicative of fecal pollution have been recovered in Cladophora mats, with counts of E. coli and enterococci often exceeding 100,000 CFU/g dry weight (Byappanahalli et al 2003a;Ksoll et al 2007;Ishii et al 2006a;Englebert et al 2008b). The U.S. Environmental Protection Agency (EPA) established recreational water quality criteria based on epidemiological studies linking E. coli concentrations to gastroenteritis illness in swimmers using doi: 10.2166/wst.2010.230 Great Lakes beaches (U.S. EPA 1986; Wade et al 2008). Kleinheinz & Englebert (2005) suggest the risk associated with E. coli washing out of mats may not be the same as with E. coli presumably originating from anthropogenic sources (e.g.…”

Section: The Majority Of These Investigations Have Addressedmentioning

confidence: 99%

Cladophora in the Great Lakes: impacts on beach water quality and human health

Verhougstraete

Byappanahalli

Rose

et al. 2010

Water Science and Technology

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Cladophora in the Great Lakes grows rapidly during the warm summer months, detaches, and becomes free-floating mats as a result of environmental conditions, eventually becoming stranded on recreational beaches. Cladophora provides protection and nutrients, which allow enteric bacteria such as Escherichia coli, enterococci, Shigella, Campylobacter, and Salmonella to persist and potentially regrow in the presence of the algae. As a result of wind and wave action, these microorganisms can detach and be released to surrounding waters and can influence water quality. Enteric bacterial pathogens have been detected in Cladophora mats; E. coli and enterococci may populate to become part of the naturalized microbiota in Cladophora; the high densities of these bacteria may affect water quality, resulting in unnecessary beach closures. The continued use of traditional fecal indicators at beaches with Cladophora presence is inadequate at accurately predicting the presence of fecal contamination. This paper offers a substantial review of available literature to improve the knowledge of Cladophora impacts on water quality, recreational water monitoring, fecal indicator bacteria and microorganisms, and public health and policy.

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“…S. aureus is commonly detected at recreational beaches in both seawater and sand (32)(33)(34)(35)(36), suggesting that the recreational water environment may be an important reservoir for S. aureus. Epidemiology studies have found associations between recreational water contact and skin ailments (37)(38)(39)(40), further pointing to recreational water exposure as a transmission route for pathogenic S. aureus.…”

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confidence: 99%

Staphylococcus aureus Strain Newman Photoinactivation and Cellular Response to Sunlight Exposure

McClary

Sassoubre

Boehm

2017

Appl Environ Microbiol

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Sunlight influences microbial water quality of surface waters. Previous studies have investigated photoinactivation mechanisms and cellular photostress responses of fecal indicator bacteria (FIB), including Escherichia coli and enterococci, but further work is needed to characterize photostress responses of bacterial pathogens. Here we investigate the photoinactivation of Staphylococcus aureus (strain Newman), a pigmented, waterborne pathogen of emerging concern. We measured photodecay using standard culture-based assays and cellular membrane integrity and investigated photostress response by measuring the relative number of mRNA transcripts of select oxidative stress, DNA repair, and metabolism genes. Photoinactivation experiments were performed in both oxic and anoxic systems to further investigate the role of oxygen-mediated and non-oxygen-mediated photoinactivation mechanisms. S. aureus lost culturability much faster in oxic systems than in anoxic systems, indicating an important role for oxygen in photodecay mechanisms. S. aureus cell membranes were damaged by sunlight exposure in anoxic systems but not in oxic systems, as measured by cell membrane permeability to propidium iodide. After sunlight exposure, S. aureus increased expression of a gene coding for methionine sulfoxide reductase after 12 h of sunlight exposure in the oxic system and after 6 h of sunlight exposure in the anoxic system, suggesting that methionine sulfoxide reductase is an important enzyme for defense against both oxygen-dependent and oxygen-independent photostresses. This research highlights the importance of oxygen in bacterial photoinactivation in environmentally relevant systems and the complexity of the bacterial photostress response with respect to cell structure and transcriptional regulation.IMPORTANCE Staphylococcus aureus is a pathogenic bacterium that causes gastrointestinal, respiratory, and skin infections. In severe cases, S. aureus infection can lead to life-threatening diseases, including pneumonia and sepsis. Cases of communityacquired S. aureus infection have been increasing in recent years, pointing to the importance of considering S. aureus transmission pathways outside the hospital environment. Associations have been observed between recreational water contact and staphylococcal skin infections, suggesting that recreational waters may be an important environmental transmission pathway for S. aureus. However, prediction of human health risk in recreational waters is hindered by incomplete knowledge of pathogen sources, fate, and transport in this environment. This study is an in-depth investigation of the inactivation of a representative strain of S. aureus by sunlight exposure, one of the most important factors controlling the fate of microbial contaminants in clear waters, which will improve our ability to predict water quality changes and human health risk in recreational waters.KEYWORDS Staphylococcus aureus, coastal waters, enterococci, fecal indicator bacteria, photoinactivation

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High Sensitivity of Children to Swimming-Associated Gastrointestinal Illness

Abstract: Measurement of the indicator bacteria Enterococci in recreational water using a rapid QPCR method predicted swimming-associated GI illness at freshwater beaches polluted by sewage discharge. Children at 10 years or younger were at greater risk for GI illness following exposure.

Cited by 254 publications

References 25 publications

Alternative Fecal Indicators and Their Empirical Relationships with Enteric Viruses, Salmonella enterica, and Pseudomonas aeruginosa in Surface Waters of a Tropical Urban Catchment

Alternative Fecal Indicators and Their Empirical Relationships with Enteric Viruses, Salmonella enterica, and Pseudomonas aeruginosa in Surface Waters of a Tropical Urban Catchment

Cladophora in the Great Lakes: impacts on beach water quality and human health

Staphylococcus aureus Strain Newman Photoinactivation and Cellular Response to Sunlight Exposure

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