Building water as a source of healthcare associated infections

Building water as a source of healthcare associated infections

Muhammad Atif Nisar¹, Kirstin Ross¹, Melissa Brown^1,2, Richard Bentham¹, Giles Best^3,4, James Xi⁵, Jason Hinds^2,5, Claire Hayward¹, Sophie Leterme^1,2, Tamar Jamieson^1,2, Harriet Whiley^1,2, ,

¹College of Science and Engineering, Flinders University, Bedford Park, SA, Australia
²ARC Training Centre for Biofilm Research and Innovation, Flinders University, Bedford Park, SA, Australia
³College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
⁴Flow Cytometry Facility, Flinders University, Bedford Park, SA, Australia
⁵Enware Australia Pty Ltd, Caringbah, NSW, Australia












Introduction
Drinking water has been described as the most underestimated and potentially controllable source of healthcare associated infections (HAIs). It is estimated that water accounts for 20% of HAIs and in the USA 20-50% of nosocomial Pseudomonas aeruginosa cases are waterborne.

Methods
We have conducted several studies investigating factors that promote the prevalence of waterborne pathogens in hospitals.

1)Hospital water and biofilm samples were analysed using culture, flow cytometry and molecular techniques to investigate the relationships between Legionella, Pseudomonas, Acanthamoeba, Vermamoeba with changes in water flow and the temperature was measured using the Enware Smart Flow monitoring system.

2)16S rRNA sequencing was conducted to examine how the hospital water and biofilm microbiome was influenced by incoming water and changes in water flow and temperature arising through intermittent usage.

3)A model plumbing system was established and used to examine the influence of brass versus stainless steel plumbing material on lead leaching and Acinetobacter baumannii, P. aeruginosa, Mycobacterium avium complex and A. polyphaga proliferation.

Results
1)Stagnation (<2 hr flow per month) resulted in increased concentrations of waterborne pathogens. 2)The hospital building water microbiome was shaped by incoming water quality and building water flow dynamics that arise through usage. 3)In both the stainless steel and brass plumbing models, extended stagnation resulted in lead concentrations above drinking water guidelines. Stainless steel materials supported the growth of waterborne pathogens to a greater extent than brass. Conclusion Improved management of building water can reduce the risk of healthcare association infection.

Biography

Dr Harriet Whiley is an Associate Professor in Environmental Health at Flinders University and Deputy Director of the ARC ITTC for Biofilm Research & Innovation. As an environmental microbiologist and accredited Environmental Health Officer her research is aimed at informing best practice control of microbes in the environment to protect human health. She is passionate about collaborative research with industry and government partners to facilitate the feedback loop between research, regulation, and practice. She actively supports industry research and is a director of Microbial Research and Testing Services