Epidemiology and Ecology of Opportunistic Premise Plumbing Pathogens: Legionella pneumophila, Mycobacterium avium, and Pseudomonas aeruginosa.
Epidemiology and Ecology of Opportunistic Premise Plumbing Pathogens: Legionella pneumophila, Mycobacterium avium, and Pseudomonas aeruginosa.
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DOI：
10.1289/ehp.1408692
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发表时间：
2015-08
影响因子：
10.4
通讯作者：
Edwards MA
中科院分区：
文献类型：
--
作者：
Falkinham JO 3rd;Hilborn ED;Arduino MJ;Pruden A;Edwards MA
嗜肺军团菌、鸟分枝杆菌和铜绿假单胞菌是机会性前提管道病原体（OPPPs），它们在家庭管道中持续存在并生长，这些管道是它们与人类共享的栖息地。由这些OPPPs引起的感染涉及具有预先存在的风险因素的个体，并且经常需要住院治疗。本报告的目的是提醒专业人员注意OPPP的影响，30%的人口可能暴露于OPPP，以及需要制定减少OPPP暴露的方法。我们在此提出了这三种细菌OPPPs的流行病学和生态学的审查，特别是确定共同和独特的功能。水研究基金会主办的研讨会聚集了来自美国各地的专家，以审查OPPP的特点，找出问题，并制定一份研究优先事项清单，以解决与日益增加的OPPP相关疾病有关的关键知识差距。OPPPs具有消毒剂抗性和供水系统或房屋管道中生物膜生长的共同特征。因此，它们与人类共享许多栖息地（例如，淋浴），可能导致暴露和感染。受OPPP感染的个体的频率正在上升，并可能随着风险个体数量的增加而继续上升。需要改进OPPP疾病的报告，并增加对控制饮用水分配系统和房屋管道中OPPP持续性和生长的遗传、生理和结构特征的理解。由于广泛有效的社区一级工程干预措施，以控制OPPPs尚未确定，因为有风险的个人的数量将继续上升，这是可能的OPPPs相关的感染将继续增加。但是，个人可以采取措施（例如，提高热水器温度和过滤水），以减少家庭暴露。Falkinham JO III，Hilborn艾德，Arduino MJ，Pruden A，Edwards MA. 2015.机会性前提管道病原体的流行病学和生态学：嗜肺军团菌，鸟分枝杆菌和铜绿假单胞菌。环境健康展望123：749-758; http://dx.doi.org/10.1289/ehp.1408692
Legionella pneumophila, Mycobacterium avium, and Pseudomonas aeruginosa are opportunistic premise plumbing pathogens (OPPPs) that persist and grow in household plumbing, habitats they share with humans. Infections caused by these OPPPs involve individuals with preexisting risk factors and frequently require hospitalization. The objectives of this report are to alert professionals of the impact of OPPPs, the fact that 30% of the population may be exposed to OPPPs, and the need to develop means to reduce OPPP exposure. We herein present a review of the epidemiology and ecology of these three bacterial OPPPs, specifically to identify common and unique features. A Water Research Foundation–sponsored workshop gathered experts from across the United States to review the characteristics of OPPPs, identify problems, and develop a list of research priorities to address critical knowledge gaps with respect to increasing OPPP-associated disease. OPPPs share the common characteristics of disinfectant resistance and growth in biofilms in water distribution systems or premise plumbing. Thus, they share a number of habitats with humans (e.g., showers) that can lead to exposure and infection. The frequency of OPPP-infected individuals is rising and will likely continue to rise as the number of at-risk individuals is increasing. Improved reporting of OPPP disease and increased understanding of the genetic, physiologic, and structural characteristics governing the persistence and growth of OPPPs in drinking water distribution systems and premise plumbing is needed. Because broadly effective community-level engineering interventions for the control of OPPPs have yet to be identified, and because the number of at-risk individuals will continue to rise, it is likely that OPPP-related infections will continue to increase. However, it is possible that individuals can take measures (e.g., raise hot water heater temperatures and filter water) to reduce home exposures. Falkinham JO III, Hilborn ED, Arduino MJ, Pruden A, Edwards MA. 2015. Epidemiology and ecology of opportunistic premise plumbing pathogens: Legionella pneumophila, Mycobacterium avium, and Pseudomonas aeruginosa. Environ Health Perspect 123:749–758; http://dx.doi.org/10.1289/ehp.1408692