Falkinham Joseph O, Hilborn Elizabeth D, Arduino Matthew J, Pruden Amy, Edwards Marc A
Department of Biological Sciences, Virginia Tech, Blacksburg, Virginia, USA.
Environ Health Perspect. 2015 Aug;123(8):749-58. doi: 10.1289/ehp.1408692. Epub 2015 Mar 20.
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.
嗜肺军团菌、鸟分枝杆菌和铜绿假单胞菌是机会性管道病原体（OPPPs），它们在家庭管道中持续存在并生长，这些管道也是它们与人类共有的栖息地。由这些OPPPs引起的感染涉及已有危险因素的个体，且常常需要住院治疗。
本报告的目的是提醒专业人员注意OPPPs的影响、30%的人口可能接触到OPPPs这一事实，以及开发减少OPPPs暴露方法的必要性。我们在此对这三种细菌性OPPPs的流行病学和生态学进行综述，特别旨在识别其共同特征和独特特征。
由水研究基金会赞助的一次研讨会召集了来自美国各地的专家，以审查OPPPs的特征、识别问题，并制定一份研究优先事项清单，以填补与增加OPPPs相关疾病有关的关键知识空白。
OPPPs具有抗消毒剂和在配水系统或建筑物管道中的生物膜中生长的共同特征。因此，它们与人类共享许多栖息地（如淋浴设施），这可能导致暴露和感染。OPPPs感染个体的频率正在上升，并且随着高危个体数量的增加可能会继续上升。需要改进OPPPs疾病的报告，并增进对饮用水分配系统和建筑物管道中OPPPs持续存在和生长的遗传、生理和结构特征的了解。
由于尚未确定广泛有效的社区层面控制OPPPs的工程干预措施，并且由于高危个体数量将继续增加，OPPPs相关感染可能会继续增加。然而，个人有可能采取措施（如提高热水器温度和过滤水）以减少家庭暴露。
