Mycobacterial Aerosols and Respiratory Disease

Falkinham, Joseph O.

doi:10.3201/eid0907.020415

Cited by 149 publications

(104 citation statements)

References 35 publications

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“…It has been hypothesized that the rise in pulmonary infections by nontuberculous mycobacteria (NTM) over recent decades is linked to increased use of showers rather than baths (5). Immune-compromised populations are on the rise; thus, identification of anthropogenic reservoirs of potential pathogens is of public health concern (3,6).…”

mentioning

confidence: 99%

“…Shower aerosol particles can be sufficiently small to carry bacteria deep into the airways (1). Pulmonary disease and other health risks such as asthma, bronchitis, and hypersensitivity pneumonitis are associated with inhalation of both viable bacteria and inviable microorganisms or their components (2)(3)(4). It has been hypothesized that the rise in pulmonary infections by nontuberculous mycobacteria (NTM) over recent decades is linked to increased use of showers rather than baths (5).…”

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confidence: 99%

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Opportunistic pathogens enriched in showerhead biofilms

Feazel

Baumgartner²,

Peterson³

et al. 2009

Proc. Natl. Acad. Sci. U.S.A.

497

364

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The environments we humans encounter daily are sources of exposure to diverse microbial communities, some of potential concern to human health. In this study, we used culture-independent technology to investigate the microbial composition of biofilms inside showerheads as ecological assemblages in the human indoor environment. Showers are an important interface for human interaction with microbes through inhalation of aerosols, and showerhead waters have been implicated in disease. Although opportunistic pathogens commonly are cultured from shower facilities, there is little knowledge of either their prevalence or the nature of other microorganisms that may be delivered during shower usage. To determine the composition of showerhead biofilms and waters, we analyzed rRNA gene sequences from 45 showerhead sites around the United States. We find that variable and complex, but specific, microbial assemblages occur inside showerheads. Particularly striking was the finding that sequences representative of non-tuberculous mycobacteria (NTM) and other opportunistic human pathogens are enriched to high levels in many showerhead biofilms, >100-fold above background water contents. We conclude that showerheads may present a significant potential exposure to aerosolized microbes, including documented opportunistic pathogens. The health risk associated with showerhead microbiota needs investigation in persons with compromised immune or pulmonary systems.bioaerosols ͉ Mycobacterium avium complex ͉ Non-tuberculous mycobacteria ͉ public health ͉ rRNA metagenomics

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mentioning

confidence: 99%

mentioning

confidence: 99%

Opportunistic pathogens enriched in showerhead biofilms

Feazel

Baumgartner²,

Peterson³

et al. 2009

Proc. Natl. Acad. Sci. U.S.A.

497

364

View full text Add to dashboard Cite

show abstract

“…For example, toxic or inflammatory pneumonia, bronchitis, and asthma are of growing public health concern and do not depend on viability of microbes to produce effect. Although there is abundant evidence to suggest that airborne microorganisms or their components can cause serious respiratory illness in indoor environments (11)(12)(13), there have been few systematic investigations of bioaerosols generated by warm-water pools and their appurtenances.…”

mentioning

confidence: 99%

Molecular identification of potential pathogens in water and air of a hospital therapy pool

Angenent

Kelley

Amand

et al. 2005

Proc. Natl. Acad. Sci. U.S.A.

219

149

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Indoor warm-water therapy pool workers in a Midwestern regional hospital were diagnosed with non-tuberculosis pulmonary hypersensitive pneumonitis and Mycobacterium avium infections. In response, we conducted a multiseason survey of microorganisms present in this therapy pool water, in biofilms associated with the pool containment walls, and in air immediately above the pool. The survey used culture, microscopy, and culture-independent molecular phylogenetic analyses. Although outfitted with a state-of-theart UV-peroxide disinfection system, the numbers of bacteria in the therapy pool water were relatively high compared with the potable water used to fill the pool. Regardless of the source, direct microscopic counts of microbes were routinely Ϸ1,000 times greater than conventional plate counts. Analysis of clone libraries of small subunit rRNA genes from environmental DNA provided phylogenetic diversity estimates of the microorganisms collected in and above the pool. A survey of >1,300 rRNA genes yielded a total of 628 unique sequences, the most common of which was nearly identical to that of M. avium strains. The high proportion of clones with different Mycobacterium spp. rRNA genes suggested that such organisms comprised a significant fraction of microbes in the pool water (to >30%) and preferentially partition into aerosols (to >80%) relative to other waterborne bacteria present. The results of the study strongly validate aerosol partitioning as a mechanism for disease transfer in these environments. The results also show that culture protocols currently used by public health facilities and agencies are seriously inadequate for the detection and enumeration of potential pathogens.16S rRNA genes ͉ bioaerosols ͉ hypersensitive pneumonitis ͉ molecular survey ͉ Mycobacterium

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“…The infectious agents recovered from Awka, Anambra State, Nigeria swimming pools water include a variety of pathogens including bacteria [5,6]. In addition to infections due to acknowledged pathogens, infections due to opportunistic microorganisms such as Mycobacterium fortuitum, Mycobacterium chelonei and Mycobacterium marinum are reported too which are able to cause mild to severe disease in immuno competent and immuno depressed individuals [7,8]. Most of the waterborne outbreaks of gastrointestinal diseases such as Salmonellosis have been associated with recreational exposure [9].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Bacteriological Quality of Outdoor Public Swimming Pools in Awka, Anambra State, Nigeria

Samuel¹

2017

CAJPH

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Abstract:Fifteen outdoor public swimming pools in Awka, Nigeria were assessed bacteriologically before and after use by bathers to determine their suitability for bathing purposes. The total bacterial, total coliform, faecal coliform, Staphylococcal and Pseudomonas counts were carried out using standard methods. The total bacterial count before and after use respectively was 10-160 cfu/ml and 100-280 cfu/ml; total coliform count, 3-87cfu/100ml and 40-120 cfu/100ml; Staphylococcal count, 0-70 cfu/ml and 0-169 cfu/ml while faecal coliforms and Pseudomonas were not detected in the samples. The bacteria were identified as klebsiella pneumoniae, Proteus mirabilis, klebsiella oxytoca, Enterobacter cloacae, Citrobacter freundii, Salmonella typhi, Bacillus licheniformis Staphylococcus aureus and Staphylococcus epidermidis. Klebsiella pneumoniae was detected in majority of the samples before and after use while Bacillus licheniformis, Citrobacter freundii and Salmonella typhi were each detected in one sample only before and after use. Klebsiella pneumoniae also had the highest occurence of 25.0% and 17.1% before and after use while Bacillus licheniformis had the lowest occurrence of 4.8% and 7.3% before and after use. None of the pools met the World Health Organization standard for coliforms therefore adequate and frequent treatment as well as regular bacteriological analyses of such pools are recommended.

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Mycobacterial Aerosols and Respiratory Disease

Cited by 149 publications

References 35 publications

Opportunistic pathogens enriched in showerhead biofilms

Opportunistic pathogens enriched in showerhead biofilms

Molecular identification of potential pathogens in water and air of a hospital therapy pool

Evaluation of the Bacteriological Quality of Outdoor Public Swimming Pools in Awka, Anambra State, Nigeria

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