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      Pseudomonas aeruginosa in premise plumbing of large buildings

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          Abstract

          Pseudomonas aeruginosa is an opportunistic bacterial pathogen that is widely occurring in the environment and is recognized for its capacity to form or join biofilms. The present review consolidates current knowledge on P. aeruginosa ecology and its implication in healthcare facilities premise plumbing. The adaptability of P. aeruginosa and its capacity to integrate the biofilm from the faucet and the drain highlight the role premise plumbing devices can play in promoting growth and persistence. A meta‐analysis of P. aeruginosa prevalence in faucets (manual and electronic) and drains reveals the large variation in device positivity reported and suggest the high variability in the sampling approach and context as the main reason for this variation. The effects of the operating conditions that prevail within water distribution systems (disinfection, temperature, and hydraulic regime) on the persistence of P. aeruginosa are summarized. As a result from the review, recommendations for proactive control measures of water contamination by P. aeruginosa are presented. A better understanding of the ecology of P. aeruginosa and key influencing factors in premise plumbing are essential to identify culprit areas and implement effective control measures.

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          NHSN annual update: antimicrobial-resistant pathogens associated with healthcare-associated infections: annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007.

          Alicia I. Hidron, Jonathan Edwards, Jean Patel … (2008)
          To describe the frequency of selected antimicrobial resistance patterns among pathogens causing device-associated and procedure-associated healthcare-associated infections (HAIs) reported by hospitals in the National Healthcare Safety Network (NHSN). Data are included on HAIs (ie, central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumonia, and surgical site infections) reported to the Patient Safety Component of the NHSN between January 2006 and October 2007. The results of antimicrobial susceptibility testing of up to 3 pathogenic isolates per HAI by a hospital were evaluated to define antimicrobial-resistance in the pathogenic isolates. The pooled mean proportions of pathogenic isolates interpreted as resistant to selected antimicrobial agents were calculated by type of HAI and overall. The incidence rates of specific device-associated infections were calculated for selected antimicrobial-resistant pathogens according to type of patient care area; the variability in the reported rates is described. Overall, 463 hospitals reported 1 or more HAIs: 412 (89%) were general acute care hospitals, and 309 (67%) had 200-1,000 beds. There were 28,502 HAIs reported among 25,384 patients. The 10 most common pathogens (accounting for 84% of any HAIs) were coagulase-negative staphylococci (15%), Staphylococcus aureus (15%), Enterococcus species (12%), Candida species (11%), Escherichia coli (10%), Pseudomonas aeruginosa (8%), Klebsiella pneumoniae (6%), Enterobacter species (5%), Acinetobacter baumannii (3%), and Klebsiella oxytoca (2%). The pooled mean proportion of pathogenic isolates resistant to antimicrobial agents varied significantly across types of HAI for some pathogen-antimicrobial combinations. As many as 16% of all HAIs were associated with the following multidrug-resistant pathogens: methicillin-resistant S. aureus (8% of HAIs), vancomycin-resistant Enterococcus faecium (4%), carbapenem-resistant P. aeruginosa (2%), extended-spectrum cephalosporin-resistant K. pneumoniae (1%), extended-spectrum cephalosporin-resistant E. coli (0.5%), and carbapenem-resistant A. baumannii, K. pneumoniae, K. oxytoca, and E. coli (0.5%). Nationwide, the majority of units reported no HAIs due to these antimicrobial-resistant pathogens.
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            Recent findings on the viable but nonculturable state in pathogenic bacteria.

            James Oliver (2010)
            Many bacteria, including a variety of important human pathogens, are known to respond to various environmental stresses by entry into a novel physiological state, where the cells remain viable, but are no longer culturable on standard laboratory media. On resuscitation from this 'viable but nonculturable' (VBNC) state, the cells regain culturability and the renewed ability to cause infection. It is likely that the VBNC state is a survival strategy, although several interesting alternative explanations have been suggested. This review describes the VBNC state, the various chemical and physical factors known to induce cells into this state, the cellular traits and gene expression exhibited by VBNC cells, their antibiotic resistance, retention of virulence and ability to attach and persist in the environment, and factors that have been found to allow resuscitation of VBNC cells. Along with simple reversal of the inducing stresses, a variety of interesting chemical and biological factors have been shown to allow resuscitation, including extracellular resuscitation-promoting proteins, a novel quorum-sensing system (AI-3) and interactions with amoeba. Finally, the central role of catalase in the VBNC response of some bacteria, including its genetic regulation, is described.
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              Microorganisms resistant to free-living amoebae.

              G Greub, D Raoult (2004)
              Free-living amoebae feed on bacteria, fungi, and algae. However, some microorganisms have evolved to become resistant to these protists. These amoeba-resistant microorganisms include established pathogens, such as Cryptococcus neoformans, Legionella spp., Chlamydophila pneumoniae, Mycobacterium avium, Listeria monocytogenes, Pseudomonas aeruginosa, and Francisella tularensis, and emerging pathogens, such as Bosea spp., Simkania negevensis, Parachlamydia acanthamoebae, and Legionella-like amoebal pathogens. Some of these amoeba-resistant bacteria (ARB) are lytic for their amoebal host, while others are considered endosymbionts, since a stable host-parasite ratio is maintained. Free-living amoebae represent an important reservoir of ARB and may, while encysted, protect the internalized bacteria from chlorine and other biocides. Free-living amoebae may act as a Trojan horse, bringing hidden ARB within the human "Troy," and may produce vesicles filled with ARB, increasing their transmission potential. Free-living amoebae may also play a role in the selection of virulence traits and in adaptation to survival in macrophages. Thus, intra-amoebal growth was found to enhance virulence, and similar mechanisms seem to be implicated in the survival of ARB in response to both amoebae and macrophages. Moreover, free-living amoebae represent a useful tool for the culture of some intracellular bacteria and new bacterial species that might be potential emerging pathogens.
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                Author and article information

                Contributors
                Eric Déziel:
                ORCID: http://orcid.org/0000-0002-4609-0115
                eric.deziel@iaf.inrs.ca
                Journal
                Journal ID (nlm-ta): Microbiologyopen
                Journal ID (iso-abbrev): Microbiologyopen
                Journal ID (doi): 10.1002/(ISSN)2045-8827
                Journal ID (publisher-id): MBO3
                Title: MicrobiologyOpen
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Electronic): 2045-8827
                Publication date (Electronic): 28 June 2016
                Publication date Collection: December 2016
                Volume: 5
                Issue: 6 ( doiID: 10.1002/mbo3.2016.5.issue-6 )
                Pages: 937-956
                Affiliations
                [ 1 ] Department of Civil EngineeringPolytechnique Montréal Montréal QCCanada
                [ 2 ]INRS‐Institut Armand‐Frappier Laval QCCanada
                Author notes
                [*] [* ] Correspondence

                Eric Déziel, INRS-Institut Armand-Frappier, 531 bd des Prairies, Laval, QC H7V 1B7, Canada.

                Email: eric.deziel@ 123456iaf.inrs.ca

                Author information
                http://orcid.org/0000-0002-4609-0115
                Article
                Publisher ID: MBO3391
                DOI: 10.1002/mbo3.391
                PMC ID: 5221438
                PubMed ID: 27353357
                SO-VID: d1808f02-102f-4004-9dc3-ffe2358ff815
                Copyright © © 2016 The Authors. MicrobiologyOpen published by John Wiley & Sons Ltd.
                License:

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 11 February 2016
                Date revision received : 01 June 2016
                Date accepted : 06 June 2016
                Page count
                Figures: 0, Tables: 2, Pages: 20, Words: 19326
                Funding
                Funded by: NSERC Industrial Drinking Water Chair of Polytechnique Montréal and industrial partners
                Categories
                Subject: Review
                Subject: Reviews
                Custom metadata
                source-schema-version-number 2.0
                component-id mbo3391
                cover-date December 2016
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_NLMPMC version:5.0.0 mode:remove_FC converted:09.01.2017

                ScienceOpen disciplines: Microbiology & Virology
                Keywords: disinfection,environmental factors,faucets,healthcare facilities,premise plumbing,pseudomonas aeruginosa
                Data availability:
                ScienceOpen disciplines: Microbiology & Virology
                Keywords: disinfection, environmental factors, faucets, healthcare facilities, premise plumbing, pseudomonas aeruginosa

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