Indicator microbes correlate with pathogenic bacteria, yeasts and helminthes in sand at a subtropical recreational beach site

A scoping review of waterborne and water-related disease in the Florida environment from 1999 to 2022

Florida's environments are suitable reservoirs for many disease-causing agents. Pathogens and toxins in Florida waterways have the potential to infect mosquito vectors, animals, and human hosts. Through a scoping review of the scientific literature published between 1999 and 2022, we examined the presence of water-related pathogens, toxins, and toxin-producers in the Florida environment and the potential risk factors for human exposure. Nineteen databases were searched using keywords relating to the waterborne, water-based toxins, and water-related vector-borne diseases which are reportable to the Florida Department of Health. Of the 10,439 results, 84 titles were included in the final qualitative analysis. The resulting titles included environmental samples of water, mosquitoes, algae, sand, soil/sediment, air, food, biofilm, and other media. Many of the waterborne, water-related vector-borne, and water-based toxins and toxin-producers of public health and veterinary importance from our search were found to be present in Florida environments. Interactions with Florida waterways can expose humans and animals to disease and toxins due to nearby human and/or animal activity, proximal animal or human waste, failing or inadequate water and/or sanitation, weather patterns, environmental events, and seasonality, contaminated food items, preference of agent for environmental media, high-risk populations, urban development and population movement, and unregulated and unsafe environmental activities. A One Health approach will be imperative to maintaining healthy waterways and shared environments throughout the state to protect the health of humans, animals, and our ecosystems.

Endotoxin, a novel biomarker for the rapid risk assessment of faecal contamination of coastal and transitional waters

Current methods for testing water for faecal contamination rely on the culture of faecal indicator bacteria (FIB; Escherichia coli and Enterococci) that take 24-48 h, which leads to delays in taking proactive measures and poses a risk to public health. More rapid methods are therefore required. Here, we have tested a rapid, portable assay (Bacterisk) that detects the bacterial biomarker endotoxin in 30 min to quantify the bacterial biomass present, to evaluate 159 coastal water samples and to compare the results with the traditional culture of FIB. There was a significant correlation between the Bacterisk data given in endotoxin risk (ER) units and FIB culture that could accurately distinguish between poor and sufficient or good quality bathing water using the EU bathing directive values. Receiver operating characteristic analysis was used to determine the optimal ER threshold for coastal water samples, and the area under the curve was 0.9176 with a p-value of <0.0001. The optimal threshold was 7,300 ER units with a sensitivity of 95.45% and a specificity of 83.48%. In conclusion, we have shown that the Bacterisk assay provides a rapid and easy-to-use in situ method to assess bathing water quality.

Beach sand mycobiome: The silent threat of pathogenic fungi and toxic metal contamination for beachgoers

Emphasis is always placed on bacterial but not fungal pathogens in marine environments. We analysed the fungal diversity, functional predictions, and toxic metals and metalloids contamination in beach sand from different South African locations. Results revealed a diverse fungal community, with Ascomycota, Rozellomycota, and Basidiomycota being the dominant phyla. Functional predictions highlighted fungal metabolic pathways related to of carbohydrates, amino acids, and lipids, in different beach samples. Elevated concentrations of toxic metals and metalloids were detected in Central and Harbour beach sands, likely due to anthropogenic activities. Correlations among different elements were observed, suggesting complex interactions in the coastal environment. Fungal pathogens like Cladosporium, Fusarium, Aspergillus, and Candida in beach sands raise potential public health risk concerns. Therefore, monitoring fungal diversity (including pathogens) alongside bacterial contamination in beach environments is imperative. The results contribute to understanding fungal community dynamics, functional potential, toxic metal and metalloid contamination, and potential risks associated with beach sand ecosystems.

Seasonal Variation in Fungi in Beach Sand in Summertime: Stintino (Italy)

BACKGROUND

The goal of this study was to monitor the microbial biodiversity in beach sand that is heavily visited by tourists during the summer, and to determinate whether the high presence of bathers (around 5000 per day) can modify sand microbial composition.

METHODS

Between 2016 and 2020, 150 sand samples were collected from nine different points at La Pelosa beach in Sardinia, Italy. Non-culturing methods were used; DNA extraction and meta-barcode sequencing were performed. All samples were analyzed with sequencing methods for 16S and ITS sequences.

RESULTS

Fungal genera differ on the three beaches and in the winter/summer zones. The ITS sequence showed the most common presence of Candida during summer and Paradendryphiella in the winter. The greatest diversity was found in the dune during winter, while in other parts of the beach, there are differences between bacteria and fungi, particularly in the wash zone during the winter, with high diversity for 16S sequences but low diversity for ITS sequences.

CONCLUSIONS

It appears reasonable that the sands, even on non-urban beaches, should be included in health monitoring programs in addition to the waters, and that access to them should be regulated by limiting the number of bathers with the aim of reducing the presence of pathogenic fungal species.

Detection of enteric viruses and SARS-CoV-2 in beach sand

Beach sand harbors a diverse group of microbial organisms that may be of public health concern. Nonetheless, little is known about the presence and distribution of viruses in beach sand. In this study, the first objective was to evaluate the presence of seven viruses (Aichi virus, enterovirus, hepatitis A virus, human adenovirus, norovirus, rotavirus, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) in sands collected at public beaches. The second objective was to assess the spatial distribution of enteric viruses in beach sand. To that end, 27 beach sand samples from different beaches in Portugal were collected between November 2018 and August 2020 and analyzed for the presence of viruses. At seven beaches, samples were collected in the supratidal and intertidal zones. Results show that viruses were detected in 89 % (24/27) of the sand samples. Aichi virus was the most prevalent (74 %). Noroviruses were present in 19 % of the samples (norovirus GI - 15 %, norovirus GII - 4 %). Human adenovirus and enterovirus were detected in 48 % and 22 % of the samples, respectively. Hepatitis A virus and rotavirus were not detected. Similarly, SARS-CoV-2 in beach sand collected during the initial stages of the pandemic was also not detected. The detection of three or more viruses occurred in 15 % of the samples. Concentrations of viruses were as high as 7.2 log copies (cp)/g of sand. Enteric viruses were found in higher prevalence in sand collected from the supratidal zone compared to the intertidal zone. Human adenovirus was detected in 43 % of the supratidal and 14 % in the intertidal samples and Aichi virus in 57 % and 86 % of the intertidal and supratidal areas, respectively. Our findings suggest that beach sand can be a reservoir of enteric viruses, suggesting that it might be a vehicle for disease transmission, particularly for children, the elderly, and immunocompromised users.

Strategies for Monitoring Microbial Life in Beach Sand for Protection of Public Health

The 2021 revised guidelines of the World Health Organization recommend monitoring the quality of sand in addition to water at recreational beaches. This review provides background information about the types of beaches, the characteristics of sand, and the microbiological parameters that should be measured. Analytical approaches are described for quantifying fungi and fecal indicator bacteria from beach sand. The review addresses strategies to assess beach sand quality, monitoring approaches, sand remediation, and the proposed way forward for beach sand monitoring programs. In the proposed way forward, recommendations are provided for acceptable levels of fungi given their distribution in the environment. Additional recommendations include evaluating FIB distributions at beaches globally to assess acceptable ranges of FIB levels, similar to those proposed for fungi.

Community-Scale Wastewater Surveillance of Candida auris during an Ongoing Outbreak in Southern Nevada

Candida auris is an opportunistic fungal pathogen and an emerging global public health threat, given its high mortality among infected individuals, antifungal resistance, and persistence in healthcare environments. This study explored the applicability of wastewater surveillance for C. auris in a metropolitan area with reported outbreaks across multiple healthcare facilities. Influent or primary effluent samples were collected over 10 weeks from seven sewersheds in Southern Nevada. Pelleted solids were analyzed using an adapted quantitative polymerase chain reaction (qPCR) assay targeting the ITS2 region of the C. auris genome. Positive detection was observed in 72 of 91 samples (79%), with higher detection frequencies in sewersheds serving healthcare facilities involved in the outbreak (94 vs 20% sample positivity). Influent wastewater concentrations ranged from 2.8 to 5.7 log₁₀ gene copies per liter (gc/L), and primary clarification achieved an average log reduction value (LRV) of 1.24 ± 0.34. Presumptive negative surface water and wastewater controls were non-detect. These results demonstrate that wastewater surveillance may assist in tracking the spread of C. auris and serve as an early warning tool for public health action. These findings provide the foundation for future application of wastewater-based epidemiology (WBE) to community- or facility-level surveillance of C. auris and other high consequence, healthcare-associated infectious agents.

Caspian Sea Mycosands: The Variety and Abundance of Medically Important Fungi in Beach Sand and Water

Samples from a total of 67 stations, distributed amongst 32 cities along the Caspian Sea coastline, were collected during the summer of 2021 on sunny days. The samples were collected from each station, including both dry/wet sand and shoreline water. The grown samples were primarily analyzed for the macro/microscopic morphologic features of the fungi. Moreover, identification by PCR-RFLP was performed for yeasts, dermatophytes, and Aspergillus sp. strains. Antifungal susceptibility tests were performed for probable-isolated Aspergillus and Candida sp. A total of 268 samples were collected, from which 181 (67.54%) isolates were recovered. Yeast-like fungi and potential pathogenic black fungi were detected in 12 (6.6%) and 20 (11%) of the sand (dry/wet) samples. Potential pathogenic hyaline fungi were identified in 136 (75.1%) samples, in which Aspergillus sp. was the predominant genus and was detected in 76/136 (47.8%) samples as follows: A. section Flavi n = 44/76 (57.9%), A. section Nigri n = 19/76 (25%), A. section Nidulantes n = 9/76 (11.8%), and A. section Fumigati n = 4/76 (5.3%). The most effective azole antifungal agent was different per section: in A. section Fumigati, PSZ; in Aspergillus section Nigri, ITZ and ISZ; in A. section Flavi, EFZ; and in A. section Nidulantes, ISZ. Candida isolates were susceptible to the antifungals tested.

Fecal indicator bacteria levels at a marine beach before, during, and after the COVID-19 shutdown period and associations with decomposing seaweed and human presence

Studies are limited that evaluate seaweed as a source of bacteria to beach waters. The objective of the current study was to evaluate whether seaweed, along with humans and other animals, could be the cause of beach advisories due to elevated levels of enterococci. The monitoring period occurred a year prior to and through the COVID-19 beach shutdown period, which provided a unique opportunity to evaluate bacteria levels during prolonged periods without recreational activity. Samples of water, sediment, and seaweed were measured for enterococci by culture and qPCR, in addition to microbial source tracking by qPCR of fecal bacteria markers from humans, dogs, and birds. During periods of elevated enterococci levels in water, these analyses were supplemented by chemical source tracking of human-associated excretion markers (caffeine, sucralose, acetaminophen, ibuprofen, and naproxen). Results show that enterococci with elevated levels of human fecal markers persist in the seaweed and sediment and are the likely contributor to elevated levels of bacteria to the nearshore waters. During the shutdown period the elevated levels of enterococci in the sediment were isolated to the seaweed stranding areas. During periods when the beaches were open, enterococci were distributed more uniformly in sediment across the supratidal and intertidal zones. It is hypothesized from this study that human foot traffic may be responsible for the spread of enterococci throughout these areas. Overall, this study found high levels of enterococci in decomposing seaweed supporting the hypothesis that decomposing seaweed provides an additional substrate for enterococci to grow.

Virus contamination and infectivity in beach environment: Focus on sand and stranded material

To assess the exposure of beachgoers to viruses, a study on seawater, sand, and beach-stranded material was carried out, searching for human viruses, fecal indicator organisms, and total fungi. Moreover, for the first time, the genome persistence and infectivity of two model viruses was studied in laboratory-spiked sand and seawater samples during a one-week experiment. Viral genome was detected in 13.6 % of the environmental samples, but it was not infectious (Human Adenovirus - HAdV, and enterovirus). Norovirus and SARS-CoV-2 were not detected. The most contaminated samples were from sand and close to riverine discharges. In lab-scale experiments, the infectivity of HAdV5 decreased by ~1.5-Log₁₀ in a week, the one of Human Coronavirus-229E disappeared in <3 h in sand. The genome of both viruses persisted throughout the experiment. Our results confirm viral contamination of the beach and suggest HAdV as an index pathogen for beach monitoring and quantitative risk assessment.

Microbiological and chemical characteristics of beaches along the Taranto Gulf (Ionian Sea, Southern Italy)

Coastal habitats provide important ecosystem services, such as the maintenance of ecological sustainability, water quality regulation, nutrient recycling, and sandy beaches which are important areas for recreation and tourism. The quality of seawater is generally measured by determining the concentrations of Escherichia coli and intestinal Enterococci, which might be affected by the persistent populations of these bacteria in sand. Sand might thus be a significant source of pathogen exposure to beachgoers. The quality of coastal recreational waters can also be affected by eutrophication, water discoloration, and harmful algal blooms, which pose additional human health risks. Here, we conducted a monitoring of the beaches quality along the Taranto Gulf by determining the concentrations of fecal indicator organisms, as well as other parameters that are not traditionally measured (physicochemical parameters, Pseudomonas aeruginosa, and harmful microalgae), in shallow seawater and sand sampled from three beaches. The concentrations of bacteria were determined using both standard microbiological methods and the IDEXX system. Our results demonstrate the utility of measuring a greater number of parameters in addition to those conventionally measured, as well as the importance of assessing the health risks posed by the sand matrix. Additional work is needed to develop rapid analytical techniques that could be used to monitor the microbiological parameters of solid matrices.

Water Quality and Microbiological Contamination across the Fish Marketing Chain: A Case Study in the Peruvian Amazon (Lagoon Yarinacocha)

The contamination of the surface water of lagoons is a common problem in developing countries, and can affect fishing activities. A case study was conducted on water quality and microbiological contamination of the fishing marketing chain in the Peruvian Amazon (Laguna de Yarinacocha). The microbiological, physical–chemical and parasitological parameters of the surface water were evaluated in three points of the lagoon near the landing stage; and microbiological parameters of facilities, handlers and three species of fish (Prochilodus nigricans, Mylossoma duriventre and Siluriforme spp.). In the water, there were coliform counts ≥ 23 (Most probable number—MPN)/100 mL, Escherichia coli ≥ 3.6 MPN/100 mL, and Pseudomona spp. up to 2.2 MPN/100 mL; high turbidity and variable amounts of parasites. In facilities and handlers, high levels of coliforms, mainly Escherichia coli, and Staphylococcus aureus and Escherichia coli, were found in M. duriventre meat. A poor quality of the surface water of the lagoon is concluded that compromises part of the fishing marketing chain, mainly facilities and manipulators. Furthermore, the levels of Staphylococcus aureus and Escherichia coli in fish meat show poor handling practices and possible risk of contamination by water sources.

Climate Change Impacts on Microbiota in Beach Sand and Water: Looking Ahead

Beach sand and water have both shown relevance for human health and their microbiology have been the subjects of study for decades. Recently, the World Health Organization recommended that recreational beach sands be added to the matrices monitored for enterococci and Fungi. Global climate change is affecting beach microbial contamination, via changes to conditions like water temperature, sea level, precipitation, and waves. In addition, the world is changing, and humans travel and relocate, often carrying endemic allochthonous microbiota. Coastal areas are amongst the most frequent relocation choices, especially in regions where desertification is taking place. A warmer future will likely require looking beyond the use of traditional water quality indicators to protect human health, in order to guarantee that waterways are safe to use for bathing and recreation. Finally, since sand is a complex matrix, an alternative set of microbial standards is necessary to guarantee that the health of beach users is protected from both sand and water contaminants. We need to plan for the future safer use of beaches by adapting regulations to a climate-changing world.

An assessment of three methods for extracting bacterial DNA from beach sand

AIMS

Beach water quality is regulated by faecal indicator bacteria levels, sand is not, despite known human health risk from exposure to beach sand. We compared the performance of three methods to extract bacterial DNA from beach sand as a step toward a standard method.

METHODS AND RESULTS

The analytical sensitivity of quantitative polymerase chain reaction (qPCR) for Enterococcus was compared for the slurry (suspension, agitation, membrane filtration of supernatant), versus direct extraction using PowerSoil™ or PowerMax Soil™ kits. The slurry method had the lowest limit of detection at 20-80 gene copies g^-1 , recovered significantly more DNA, and the only method that detected Enterococcus by qPCR in all samples; therefore, the only method used in subsequent experiments. The slurry method reflected the spatial variability of Enterococcus in individual transect samples. Mean recovery efficiency of the microbial source tracking marker HF183 from wastewater spiked marine and freshwater beach sand was 100.8% and 64.1%, respectively, but varied, indicating that the mixing protocol needs improvement.

CONCLUSIONS

Among the three methods, the slurry method had the best analytical sensitivity and produced extracts that were useful for culture or molecular analysis.

SIGNIFICANCE AND IMPACT OF STUDY

Standardization of methods for extraction of bacterial DNA from sand facilitates comparisons among studies, and ultimately contributes to the safety of recreational beaches.

Trends in regional enterococci levels at marine beaches and correlations with environmental, global oceanic changes, community populations, and wastewater infrastructure

An increase in the number of advisories issued for recreational beaches across south Florida (due to the fecal indicator bacteria, enterococci) has been observed in recent years. To evaluate the possible reasons for this increase, we reviewed weekly monitoring data for 18 beaches in Miami-Dade County, Florida, for the years 2000-2019. Our objective was to evaluate this dataset for trends in enterococci levels and correlations with various factors that might have influenced enterococci levels at these beaches. For statistical analyses, we divided the 20-year period of record into 5-year increments (2000-2004, 2005-2009, 2010-2014, and 2015-2019). The Wilcoxon rank sum test was used to identify statistically significant differences between the geometric mean of different periods. When all 18 beaches were collectively considered, a significant increase (p = 0.03) in enterococci was observed during 2015-2019, compared to the prior 15-year period of record. To better understand the potential causes for this increase, correlations were evaluated with environmental parameters (rainfall, air temperature, and water temperature), global oceanic changes (sea level and Sargassum), community populations (county population estimates and beach visitation numbers), and wastewater infrastructure (sewage effluent flow rates to ocean outfalls and deep well injection). In relation to the enterococci geometric mean, the correlation with Sargassum was statistically significant at a 95% confidence interval (p = 0.035). Population (p = 0.078), air temperature (p = 0.092), and sea level (p = 0.098) were statistically significant at 90% confidence intervals. Rainfall, water temperature, beach visitation numbers, and sewage effluent flow rates via deep well injection had positive correlations but were not significant factors. Sewage effluent flow rates to ocean outfalls had a negative correlation.

Mycosands: Fungal diversity and abundance in beach sand and recreational waters - Relevance to human health

The goal of most studies published on sand contaminants is to gather and discuss knowledge to avoid faecal contamination of water by run-offs and tide-retractions. Other life forms in the sand, however, are seldom studied but always pointed out as relevant. The Mycosands initiative was created to generate data on fungi in beach sands and waters, of both coastal and freshwater inland bathing sites. A team of medical mycologists and water quality specialists explored the sand culturable mycobiota of 91 bathing sites, and water of 67 of these, spanning from the Atlantic to the Eastern Mediterranean coasts, including the Italian lakes and the Adriatic, Baltic, and Black Seas. Sydney (Australia) was also included in the study. Thirteen countries took part in the initiative. The present study considered several fungal parameters (all fungi, several species of the genus Aspergillus and Candida and the genera themselves, plus other yeasts, allergenic fungi, dematiaceous fungi and dermatophytes). The study considered four variables that the team expected would influence the results of the analytical parameters, such as coast or inland location, urban and non-urban sites, period of the year, geographical proximity and type of sediment. The genera most frequently found were Aspergillus spp., Candida spp., Fusarium spp. and Cryptococcus spp. both in sand and in water. A site-blind median was found to be 89 Colony-Forming Units (CFU) of fungi per gram of sand in coastal and inland freshwaters, with variability between 0 and 6400 CFU/g. For freshwater sites, that number was 201.7 CFU/g (0, 6400 CFU/g (p = 0.01)) and for coastal sites was 76.7 CFU/g (0, 3497.5 CFU/g). For coastal waters and all waters, the median was 0 CFU/ml (0, 1592 CFU/ml) and for freshwaters 6.7 (0, 310.0) CFU/ml (p < 0.001). The results advocate that beaches should be monitored for fungi for safer use and better management.

Cutaneous larva migrans in a beach volleyball player

Athletes playing beach volleyball come into contact with sand and may contract skin parasites. We present a case of cutaneous larva migrans in a 20-year-old Polish female beach volleyball player. The athlete participated in The World Tour in Asia (China, Malaysia, Cambodia) a month before. In the beginning, her skin lesions were misdiagnosed as allergic reactions and treated with antihistamines. The disease in the form of a pruritic, migratory serpiginous skin eruption on legs was diagnosed during routine medical examination at the National Centre for Sports Medicine in Warsaw. She was treated successfully with albendazole and cetirizine. The skin lesions resolved entirely within two weeks.

Estimating Health Risks to Children Associated with Recreational Play on Oil Spill-Contaminated Beaches

The human health impact from exposure to contaminated shorelines following an oil spill event has been investigated to some extent. However, the health risks to children have largely been characterized through the use of surveys and extrapolation from adult health outcomes. There is limited information on children's behaviors during beach play requiring assumptions made based on observations from play activities in home settings. The Beach Exposure and Child Health Study (BEACHES) quantified specific beach activities that can be used to inform human health risk assessments of children playing on beaches impacted by oil spills. The results of this study characterize children's risk of cancer from exposure to oil spill chemicals by incorporating exposure-related information collected from the BEACHES study and by assuming oral, dermal, and inhalation exposure routes. Point risk estimates are compared with a previous, similar study that applied default exposure parameter values obtained from the published literature. The point risk estimates informed by BEACHES data are one order of magnitude lower compared with the previous risk assessment, with dermal exposures the overall risk driver in both. Additional Monte Carlo simulations evaluating the BEACHES data provide ranges of health risks with the highest estimates associated with dermal and oral exposure routes.

Methicillin Resistant Staphylococcus aureus and public fomites: a review

Staphylococcus genus is a Gram-positive coccus normally associated with skin and mucous membranes of warm-blooded animals. It is part of the commensal human microflora, or found in animals, or contaminating surfaces in the community and hospital settings. Staphylococcus aureus is the most pathogenic species belonging to this genus, as it possesses a collection of virulence factors that are expressed solely to evade the immune system. The increase in the misuse of antimicrobial agents predisposed S. aureus to develop antibiotic resistance, including the resistance to methicillin which led to the emergence of Methicillin-Resistant S. aureus (MRSA). MRSA is considered one of the most dangerous nosocomial pathogens causing many hard to treat infections in hospitals and was named as Hospital Associated MRSA (HA-MRSA). Over the past 20-25 years, MRSA was isolated from community settings and thus Community Associated MRSA (CA-MRSA) has emerged. Inside hospitals, MRSA has been isolated from fomites in contact with patients, as well as staff's protective and personal items. This review highlights the worldwide prevalence of MRSA on fomites within the contexts of hospital and community settings.

Untreated sewage contamination of beach sand from a leaking underground sewage system

Thirty people (mostly children) experienced an episode of skin rash days after a sand sifting beach operation at Porto Pim Beach in Faial, Azores during June 2019. An environmental and epidemiologic investigation was conducted to identify the cause of the outbreak of skin rash. The epidemiologic investigation found that some of the patients experiencing symptoms had never entered the beach water. During the pollution period and throughout the epidemiologic investigation, faecal indicator bacteria levels (94 CFU/100 ml for intestinal enterococci and 61 CFU/100 ml for Escherichia coli) in water remained under the limits used for the ninety-five percentile calculation of an Excellent coastal and transitional bathing water defined in the Portuguese Legislation (100 CFU/100 ml for intestinal enterococci and 250 CFU/100 ml for Escherichia coli). Thus sand contact was considered as a likely primary exposure route. Sand microbiological analysis for faecal indicator organisms and electron microscopy strongly suggested faecal contamination. Chemical analysis of the sand also revealed a concomitant substance compatible with sodium-hypochlorite as analysed using gas chromatography and subsequently confirmed by free chlorine analysis. Inspection of the toilet facilities and sewage disposal system revealed a leaking sewage distribution box. Collectively, results suggest that the cause of the outbreak was the leaking underground sewage distribution box that serviced the beach toilet facilities (40 m from beach), where sodium-hypochlorite was used for cleaning and disinfection. This sewage then contaminated the surficial sands to which beach goers were exposed. Chlorine being an irritant substance, was believed to have been the cause of the symptoms given the sudden presentation and dissipation of skin rashes. No gastro-intestinal illness was reported during this episode and during the following 30 days. Like water, beach sand should also be monitored for safety, especially for areas serviced by aged infrastructure.

Children's Abrasions in Recreational Beach Areas and a Review of Possible Wound Infections

The Beach Exposure and Child Health Study (BEACHES) quantified the behavior of children at recreational beach areas to evaluate how various behaviors might affect their exposure to environmental contaminants such as bacteria and chemicals. Due to limited information in the study about abrasions, we conducted a literature review to examine how marine bacteria cause infections in open wounds. The literature review revealed possible adverse health effects from the bacterium Vibrio vulnificus due to its increasing prevalence and the severity of infection. We used data from the BEACHES study to review children's behavior and their susceptibility to abrasions. Children six years of age and younger were evaluated before and after 1 hour of play for open or healing abrasions at two beaches in Miami-Dade County, Florida (Crandon and Haulover), and two beaches in Galveston County, Texas (Stewart and Seawall). The children were videotaped to monitor their activities and to determine the behavior that would increase their susceptibility to obtaining abrasions. Overall, 58.2% of the children had at least one existing abrasion before playing at the beach, while 8.2% of the children acquired a new abrasion during their time at the beach. Children who acquired new abrasions most often played in the sea water, with new abrasions most frequently occurring on exposed skin surfaces such as the knees. Proper wound care before and after visiting the beach should be encouraged to minimize the risk of bacterial infection, especially considering the possible detrimental impacts that can be caused by some bacterial pathogens through wound exposures.

Assessment for oil spill chemicals: Current knowledge, data gaps, and uncertainties addressing human physical health risk

Limited models are available to estimate human physical health risks (e.g., probability of outcomes such as lung disease, cancer, skin disease) from exposure to chemicals resulting from oil spills that may occur offshore and later impact coastline spills. An approach is presented to assess physical health risks from oil spills that involves establishing a platform capable of assessing aggregate health risk (via inhalation, ingestion, and dermal exposure routes). Gaps include the need to develop models reflecting oil spill concentration distributions given the influence from environmental, physical, biological and chemical factors. Human activities need to be quantified for different populations including emergency response workers, fishermen, shellfish consumers, and children who play at beaches that may be impacted by oil spills. Work is also needed in developing comprehensive toxicological profiles for the majority of chemicals - including dispersants found in oil spills - and to estimate toxicity from mixtures.

Impacts of a changing earth on microbial dynamics and human health risks in the continuum between beach water and sand

Although infectious disease risk from recreational exposure to waterborne pathogens has been an active area of research for decades, beach sand is a relatively unexplored habitat for the persistence of pathogens and fecal indicator bacteria (FIB). Beach sand, biofilms, and water all present unique advantages and challenges to pathogen introduction, growth, and persistence. These dynamics are further complicated by continuous exchange between sand and water habitats. Models of FIB and pathogen fate and transport at beaches can help predict the risk of infectious disease from beach use, but knowledge gaps with respect to decay and growth rates of pathogens in beach habitats impede robust modeling. Climatic variability adds further complexity to predictive modeling because extreme weather events, warming water, and sea level change may increase human exposure to waterborne pathogens and alter relationships between FIB and pathogens. In addition, population growth and urbanization will exacerbate contamination events and increase the potential for human exposure. The cumulative effects of anthropogenic changes will alter microbial population dynamics in beach habitats and the assumptions and relationships used in quantitative microbial risk assessment (QMRA) and process-based models. Here, we review our current understanding of microbial populations and transport dynamics across the sand-water continuum at beaches, how these dynamics can be modeled, and how global change factors (e.g., climate and land use) should be integrated into more accurate beachscape-based models.

Children Exposure-Related Behavior Patterns and Risk Perception Associated with Recreational Beach Use

Background: Oil spill chemicals (OSCs) result not only from the crude oil components but also from dispersants used in the clean-up activities, where some may result in adverse health effects under certain exposure and dosage conditions. One of the main populations of concern for exposure to OSCs are children, who are frequent beach users. Activities such as ingestion of and digging in sand can increase dermal and ingestion exposure. Longer times spent at the beach can also increase exposures for all routes. Objectives: The Beach Exposure and Child Health Study (BEaCHeS) was initiated to evaluate the risk of exposure to children from oil contaminants. Reported here are results for surveys collected, as a part of the project, to address exposure-related behavior patterns and risk perception for parents or guardians who visit the beach. Methods: Over 400 parental surveys were collected at four beaches, two in Miami and two in Texas, to evaluate children’s exposure related activities. Surveys consisted of three general sections: demographics, exposure, and risk perception. Surveys were analyzed in REDcap and Stata to evaluate demographic and regional differences on activities related to beach behavior and potential exposures to oil contaminants (e.g., how much time spent on beach, cleaning habits following beach activities). The statistical analysis included the mean and standard errors, along with regressions to evaluate associations between parameters. Results: Overall, the data showed high variability in how children play on the beach, influenced more by age and less by gender. Variations were also seen in certain variables by beach region (e.g., hygiene practices). By race, variations were seen in income, distance of travel to beach, and preferred method of communication for beach warning. Other important findings are reflected in the article. Discussion: The data presented here may prove useful for those evaluating children exposures to a variety of contaminants, chemical, or bacterial in origin. In addition, coastal managers may find the risk perception and general behaviors useful for planning and maintenance of beach areas.

Occurrence, antifungal susceptibility, and virulence factors of opportunistic yeasts isolated from Brazilian beaches

BACKGROUND

Opportunistic pathogenic yeast species are frequently associated with water habitats that have pollution sources of human or animal origin. Candida albicans has already been suggested as a faecal indicator microorganism for aquatic environments.

OBJECTIVES

The goal of this study was to investigate the occurrence of C. albicans and other opportunistic yeasts in sand and seawater samples from beaches in Brazil to assess their correlation with Escherichia coli, and to characterise the pathogenic potential of the yeast isolates.

METHODS

Opportunistic species (yeasts that grow at 37ºC) were isolated from sand and seawater samples from eight beaches in Brazil during the summer and the winter. Opportunistic yeast species were evaluated for their susceptibility to antifungal drugs, virulence factors, and the in vitro and in vivo biofilm formation. Strains were selected to carry out virulence tests using BALB/c mice.

FINDINGS

Several water samples could be classified as inappropriate for primary contact recreation in relation to E. coli densities. C. albicans was isolated in low densities. Of the 144 opportunistic yeasts evaluated, 61% displayed resistance or dose-dependent sensitivity to at least one tested drug, and 40% produced proteinase. Strains of C. albicans and Kodamaea ohmeri exhibited the highest rates of adhesion to buccal epithelial cells. All the C. albicans strains that were tested were able to undergo morphogenesis and form a biofilm on catheter fragments in both in vitro and in vivo experiments. It was possible to confirm the pathogenic potential of three of these strains during the disseminated infection test.

MAIN CONCLUSIONS

The identification of opportunistic yeast species in seawater and sand samples from Brazilian beaches suggest a potential risk to the health of people who use these environments for recreational purposes.

Candida tropicalis geographic population structure maintenance and dispersion in the coastal environment may be influenced by the climatic season and anthropogenic action

Candida tropicalis is a pathogenic yeast with worldwide recognition as the second or third more frequently isolated species in Latin America, for both superficial and systemic infections. Because of its high prevalence, and growing clinical interest, it is essential to understand genetic variability patterns of this important Candida species in the tropics. Besides belonging to the human normal microbiota, C. tropicalis may be found in other warm blood animals and in the environment, including water and sand of beaches. The aims of the present study were to evaluate genotypic and phenotypic variability of 62 isolates of C. tropicalis obtained from the coastal environment in Northeast Brazil using microsatellite and MALDI-TOF/MS comparisons. There was a relatively low correspondence between these typing techniques employed. Therefore, further studies are needed to consolidate the use of MALDI-TOF/MS as a yeast typing tool. Nevertheless, the two methods employed demonstrated the heterogeneity of C. tropicalis in a coastal environment. We also found relative maintenance of the population structure within the same season, which may reinforce the idea that this species presents the potential to remain in the environment for a long period of time. In addition, highly related strains were found within different geographic points of collection, demonstrating that this strain may be dispersed at long distances, probably influenced by anthropogenic actions and driven by the sea tides and wind.

Possible impacts of sea level rise on disease transmission and potential adaptation strategies, a review

Sea levels are projected to rise in response to climate change, causing the intrusion of sea water into land. In flat coastal regions, this would generate an increase in shallow water covered areas with limited circulation. This scenario raises a concern about the consequences it could have on human health, specifically the possible impacts on disease transmission. In this review paper we identified three categories of diseases which are associated with water and whose transmission can be affected by sea level rise. These categories include: mosquitoborne diseases, naturalized organisms (Vibrio spp. and toxic algae), and fecal-oral diseases. For each disease category, we propose comprehensive adaptation strategies that would help minimize possible health risks. Finally, the City of Key West, Florida is analyzed as a case study, due to its inherent vulnerability to sea level rise. Current and projected adaptation techniques are discussed as well as the integration of additional recommendations, focused on disease transmission control. Given that sea level rise will likely continue into the future, the promotion and implementation of positive adaptation strategies is necessary to ensure community resilience.

Evaluation of methods to sample fecal indicator bacteria in foreshore sand and pore water at freshwater beaches

Fecal indicator bacteria (FIB) are known to accumulate in foreshore beach sand and pore water (referred to as foreshore reservoir) where they act as a non-point source for contaminating adjacent surface waters. While guidelines exist for sampling surface waters at recreational beaches, there is no widely-accepted method to collect sand/sediment or pore water samples for FIB enumeration. The effect of different sampling strategies in quantifying the abundance of FIB in the foreshore reservoir is unclear. Sampling was conducted at six freshwater beaches with different sand types to evaluate sampling methods for characterizing the abundance of E. coli in the foreshore reservoir as well as the partitioning of E. coli between different components in the foreshore reservoir (pore water, saturated sand, unsaturated sand). Methods were evaluated for collection of pore water (drive point, shovel, and careful excavation), unsaturated sand (top 1 cm, top 5 cm), and saturated sand (sediment core, shovel, and careful excavation). Ankle-depth surface water samples were also collected for comparison. Pore water sampled with a shovel resulted in the highest observed E. coli concentrations (only statistically significant at fine sand beaches) and lowest variability compared to other sampling methods. Collection of the top 1 cm of unsaturated sand resulted in higher and more variable concentrations than the top 5 cm of sand. There were no statistical differences in E. coli concentrations when using different methods to sample the saturated sand. Overall, the unsaturated sand had the highest amount of E. coli when compared to saturated sand and pore water (considered on a bulk volumetric basis). The findings presented will help determine the appropriate sampling strategy for characterizing FIB abundance in the foreshore reservoir as a means of predicting its potential impact on nearshore surface water quality and public health risk.

Antimicrobial Susceptibility of Staphylococcus aureus Isolated from Recreational Waters and Beach Sand in Eastern Cape Province of South Africa

Background: Resistance of Staphylococcus aureus to commonly used antibiotics is linked to their ability to acquire and disseminate antimicrobial-resistant determinants in nature, and the marine environment may serve as a reservoir for antibiotic-resistant bacteria. This study determined the antibiotic sensitivity profile of S.aureus isolated from selected beach water and intertidal beach sand in the Eastern Cape Province of South Africa. Methods: Two hundred and forty-nine beach sand and water samples were obtained from 10 beaches from April 2015 to April 2016. Staphylococcus aureus was isolated from the samples using standard microbiological methods and subjected to susceptibility testing to 15 antibiotics. Methicillin-resistant Staphylococcus aureus (MRSA) was detected by susceptibility to oxacillin and growth on Brilliance MRSA II agar. Antibiotic resistance genes including mecA, femA rpoB, blaZ, ermB, ermA, ermC, vanA, vanB, tetK and tetM were screened. Results: Thirty isolates (12.3%) were positive for S. aureus by PCR with over 50% showing phenotypic resistance to methicillin. Resistance of S. aureus to antibiotics varied considerably with the highest resistance recorded to ampicillin and penicillin (96.7%), rifampicin and clindamycin (80%), oxacillin (73.3%) and erythromycin (70%). S.aureus revealed varying susceptibility to imipenem (96.7%), levofloxacin (86.7%), chloramphenicol (83.3%), cefoxitin (76.7%), ciprofloxacin (66.7%), gentamycin (63.3%), tetracycline and sulfamethoxazole-trimethoprim (56.7%), and vancomycin and doxycycline (50%). All 30 (100%) S. aureus isolates showed multiple antibiotic-resistant patterns (resistant to three or more antibiotics). The mecA, femA, rpoB, blaZ, ermB and tetM genes were detected in 5 (22.7%), 16 (53.3%), 11 (45.8%), 16 (55.2%), 15 (71.4%), and 8 (72.7%) isolates respectively; Conclusions: Results from this study indicate that beach water and sand from the Eastern Cape Province of South Africa may be potential reservoirs of antibiotic-resistant S. aureus which could be transmitted to exposed humans and animals.

Next-generation sequencing and culture-based techniques offer complementary insights into fungi and prokaryotes in beach sands

A next-generation sequencing (NGS) approach, in conjunction with culture-based methods, was used to examine fungal and prokaryotic communities for the presence of potential pathogens in beach sands throughout Portugal. Culture-based fungal enumeration revealed low and variable concentrations of the species targeted (yeasts and dermatophytes), which were underrepresented in the community characterized by NGS targeting the ITS1 region. Conversely, NGS indicated that the potentially pathogenic species Purpureocillium liliacinum comprised nearly the entire fungal community. Culturable fecal indicator bacterial concentrations were low throughout the study and unrelated to communities characterized by NGS. Notably, the prokaryotic communities characterized revealed a considerable abundance of archaea. Results highlight differences in communities between methods in beach sand monitoring but indicate the techniques offer complementary insights. Thus, there is a need to leverage culture-based methods with NGS methods, using a toolbox approach, to determine appropriate targets and metrics for beach sand monitoring to adequately protect public health.

Shotgun metagenomic sequencing reveals freshwater beach sands as reservoir of bacterial pathogens

Recreational waters and adjacent beach sands harbor complex microbial communities which may contain human pathogens that cannot be detected by conventional methods. Here, we investigate the diversity of bacterial populations inhabiting four freshwater beaches of the Great Lakes region using shotgun metagenomic sequencing approach. Our analysis suggests that average taxonomic richness and alpha diversity are significantly higher (P < 0.001) in beach sands compared to the corresponding water environments. Compared to the water environments, beach sands harbored taxa from a more diverse range of phyla, including a higher proportion of sequences from unclassified phyla. Unique phyla were also identified in sand which included species from Aquificae, Candidatus Microgenomates, Latescibacteria, and Candidatus Aminicenantes. Sequences originating from pathogens were detected in both sand and water, with some pathogens enriched in both environments. Both lakes exhibited similar community composition suggesting that geographic location did not appear to have any major impact on bacterial diversity. These findings reveal the diversity of bacterial communities of freshwater beaches and highlight the importance of monitoring pathogens in recreational beaches, especially in the sand environment of these beaches.

Toward a better guard of coastal water safety-Microbial distribution in coastal water and their facile detection

Prosperous development in marine-based tourism has raised increasing concerns over the sanitary quality of coastal waters with potential microbial contamination. The World Health Organization has set stringent standards over a list of pathogenic microorganisms posing potential threats to people with frequent coastal water exposure and has asked for efficient detection procedures for pathogen facile identification. Inspection of survey events regarding the occurrence of marine pathogens in recreational beaches in recent years has reinforced the need for the development of a rapid identification procedure. In this review, we examine the possibility of recruiting uniform molecular assays to identify different marine pathogens and the feasibility of appropriate biomarkers, including enterochelin biosynthetic genes, for general toxicity assays. The focus is not only on bacterial pathogens but also on other groups of infectious pathogens. The ultimate goal is the development of a handy method to more efficiently and rapidly detect marine pathogens.

Sources and persistence of fecal indicator bacteria and Bacteroidales in sand as measured by culture-based and culture-independent methods: A case study at Santa Monica Pier, California

This study investigated causes of persistent fecal indicator bacteria (FIB) in beach sand under the pier in Santa Monica, CA. FIB levels were up to 1,000 times higher in sand underneath the pier than that collected from adjacent to the pier, with the highest concentrations under the pier in spring and fall. Escherichia coli (EC) and enterococci (ENT) under the pier were significantly positively correlated with moisture (ρ = 0.61, p < 0.001, n = 59; ρ = 0.43, p < 0.001, n = 59, respectively), and ENT levels measured by qPCR (qENT) were much higher than those measured by membrane filtration (cENT). Microcosm experiments tested the ability of EC, qENT, cENT, and general Bacteroidales (GenBac) to persist under in-situ moisture conditions (10% and 0.1%). Decay rates of qENT, cENT, and GenBac were not significantly different from zero at either moisture level, while decay rates for EC were relatively rapid during the microcosm at 10% moisture (k = 0.7 days-1). Gull/pelican marker was detected at eight of 12 sites and no human-associated markers (TaqHF183 and HumM2) were detected at any site during a one-day site survey. Results from this study indicate that the high levels of FIB observed likely stem from environmental sources combined with high persistence of FIB under the pier.

Cross-Comparison of Human Wastewater-Associated Molecular Markers in Relation to Fecal Indicator Bacteria and Enteric Viruses in Recreational Beach Waters

Detection of human wastewater contamination in recreational waters is of critical importance to regulators due to the risks posed to public health. To identify such risks, human wastewater-associated microbial source tracking (MST) markers have been developed. At present, however, a greater understanding of the suitability of these markers for the detection of diluted human wastewater in environmental waters is necessary to predict risk. Here, we compared the process limit of detection (PLOD) and process limit of quantification (PLOQ) of six human wastewater-associated MST markers (Bacteroides HF183 [HF183], Escherichia coli H8 [EC H8], Methanobrevibacter smithiinifH, human adenovirus [HAdV], human polyomavirus [HPyV], and pepper mild mottle virus [PMMoV]) in relation to a fecal indicator bacterium (FIB), Enterococcus sp. 23S rRNA (ENT 23S), and three enteric viruses (human adenovirus serotypes 40/41 [HAdV 40/41], human norovirus [HNoV], and human enterovirus [EV]) in beach water samples seeded with raw and secondary-treated wastewater. Among the six MST markers tested, HF183 was the most sensitive measure of human fecal pollution and was quantifiable up to dilutions of 10^-6 and 10^-4 for beach water samples seeded with raw and secondary-treated wastewater, respectively. Other markers and enteric viruses were detected at various dilutions (10^-1 to 10^-5). These MST markers, FIB, and enteric viruses were then quantified in beach water (n = 12) and sand samples (n = 12) from South East Queensland (SEQ), Australia, to estimate the levels of human fecal pollution. Of the 12 sites examined, beach water and sand samples from several sites had quantifiable concentrations of HF183 and PMMoV markers. Overall, our results indicate that while HF183 is the most sensitive measure of human fecal pollution, it should be used in conjunction with a conferring viral marker to avoid overestimating the risk of gastrointestinal illness.IMPORTANCE MST is an effective tool to help utilities and regulators improve recreational water quality around the globe. Human fecal pollution poses significant public health risks compared to animal fecal pollution. Several human wastewater-associated markers have been developed and used for MST field studies. However, a head-to-head comparison in terms of their performance to detect diluted human fecal pollution in recreational water is lacking. In this study, we cross-compared the performance of six human wastewater-associated markers in relation to FIB and enteric viruses in beach water samples seeded with raw and secondary-treated wastewater. The results of this study will provide guidance to regulators and utilities on the appropriate application of MST markers for tracking the sources of human fecal pollution in environmental waters and confer human health risks.

Microbial Remobilisation on Riverbed Sediment Disturbance in Experimental Flumes and a Human-Impacted River: Implication for Water Resource Management and Public Health in Developing Sub-Saharan African Countries

Resuspension of sediment-borne microorganisms (including pathogens) into the water column could increase the health risk for those using river water for different purposes. In the present work, we (1) investigated the effect of sediment disturbance on microbial resuspension from riverbed sediments in laboratory flow-chambers and in the Apies River, Gauteng, South Africa; and (2) estimated flow conditions for sediment-borne microorganism entrainment/resuspension in the river. For mechanical disturbance, the top 2 cm of the sediment in flow-chambers was manually stirred. Simulating sudden discharge into the river, water (3 L) was poured within 30 s into the chambers at a 45° angle to the chamber width. In the field, sediment was disturbed by raking the riverbed and by cows crossing in the river. Water samples before and after sediment disturbance were analysed for Escherichia coli. Sediment disturbance caused an increase in water E. coli counts by up to 7.9-35.8 times original values. Using Shields criterion, river-flow of 0.15-0.69 m³/s could cause bed particle entrainment; while ~1.57-7.23 m³/s would cause resuspension. Thus, sediment disturbance in the Apies River would resuspend E. coli (and pathogens), with possible negative health implications for communities using such water. Therefore, monitoring surface water bodies should include microbial sediment quality.

A Review of the Field on Children's Exposure to Environmental Contaminants: A Risk Assessment Approach

Background: Children must be recognized as a sensitive population based on having biological systems and organs in various stages of development. The processes of absorption, distribution, metabolism and elimination of environmental contaminants within a child's body are considered less advanced than those of adults, making them more susceptible to disease outcomes following even small doses. Children's unique activities of crawling and practicing increased hand-to-mouth ingestion also make them vulnerable to greater exposures by certain contaminants within specific environments. Approach: There is a need to review the field of children's environmental exposures in order to understand trends and identify gaps in research, which may lead to better protection of this vulnerable and sensitive population. Therefore, explored here are previously published contemporary works in the broad area of children's environmental exposures and potential impact on health from around the world. A discussion of children's exposure to environmental contaminants is best organized under the last four steps of a risk assessment approach: hazard identification, dose-response assessment, exposure assessment (including children's activity patterns) and risk characterization. We first consider the many exposure hazards that exist in the indoor and outdoor environments, and emerging contaminants of concern that may help guide the risk assessment process in identifying focus areas for children. A section on special diseases of concern is also included. Conclusions: The field of children's exposures to environmental contaminants is broad. Although there are some well-studied areas offering much insight into children exposures, research is still needed to further our understanding of exposures to newer compounds, growing disease trends and the role of gene-environment interactions that modify adverse health outcomes. It is clear that behaviors of adults and children play a role in reducing or increasing a child's exposure, where strategies to better communicate and implement risk modifying behaviors are needed, and can be more effective than implementing   changes in the physical environment.

Sediment characteristics and microbiological contamination of beach sand - A case-study in the archipelago of Madeira

Beach sand can harbour pathogenic and opportunistic microorganisms, as well as faecal indicator bacteria that influence directly the bathing water quality. Pathogenic and opportunistic microorganisms often raise concern of exposure during beach related recreational activities. In this work, three different types of sandy beaches (natural basaltic, natural calcareous and artificial calcareous) of the Archipelago of Madeira (Portugal) were sampled for bacterial and fungal contaminants and grain size distribution, during four years (2010-2013). Following an extreme weather event in 2010, the faecal indicator bacteria levels spiked, returning to base levels shortly thereafter. The same phenomenon occurred with fungi, where potentially pathogenic fungi were the dominant group. Yeast-like fungi and dermatophytes were, however, mainly associated to months of higher usage by recreational users. Statistical analysis showed higher contamination of sediment in artificial beaches compared to natural beaches and granulometry and chemical composition of sand did not influence in the microbial loads. Instead, bather density and the influence of coastal protection structures needed to maintain the volume of artificial beach sand regarding the removal potential of wave induced currents are obvious influencing factors.

Children's Exposure to Environmental Contaminants: An Editorial Reflection of Articles in the IJERPH Special Issue Entitled, "Children's Exposure to Environmental Contaminants"

Children are at increased vulnerability to many environmental contaminants compared to adults due to their unique behavior patterns, increased contaminant intake per body weight, and developing biological systems. Depending upon their age, young children may crawl on the floor and may practice increased hand to mouth activity that may increase their dose-intake of specific contaminants that accumulate in dust and other matrices. Children are also smaller in size than adults, resulting in a greater body burden for a given contaminant dose. Because children undergo rapid transitions through particular developmental stages they are also especially vulnerable during certain growth-related time windows. A Special Issue was organized focused on the latest findings in the field of children’s environmental exposure for these reasons. This editorial introduces articles in this Special Issue and emphasizes their main findings in advancing the field. From the many articles submitted to this Special Issue from around the world, 23 were accepted and published. They focus on a variety of research areas such as children’s activity patterns, improved risk assessment methods to estimate exposures, and exposures in various contexts and to various contaminants. The future health of a nation relies on protecting the children from adverse exposures and understanding the etiology of childhood diseases. The field of children’s environmental exposures must consider improved and comprehensive research methods aimed at introducing mitigation strategies locally, nationally, and globally. We are happy to introduce a Special Issue focused on children’s environmental exposure and children’s health and hope that it contributes towards improved health of children.

Opportunistic fungal pathogen Candida glabrata circulates between humans and yellow-legged gulls

The opportunistic pathogenic yeast Candida glabrata is a component of the mycobiota of both humans and yellow-legged gulls that is prone to develop fluconazole resistance. Whether gulls are a reservoir of the yeast and facilitate the dissemination of human C. glabrata strains remains an open question. In this study, MLVA genotyping highlighted the lack of genetic structure of 190 C. glabrata strains isolated from either patients in three hospitals or fecal samples collected from gull breeding colonies located in five distinct areas along the French Mediterranean littoral. Fluconazole-resistant isolates were evenly distributed between both gull and human populations. These findings demonstrate that gulls are a reservoir of this species and facilitate the diffusion of C. glabrata and indirect transmission to human or animal hosts via environmental contamination. This eco-epidemiological view, which can be applied to other vertebrate host species, broadens our perspective regarding the reservoirs and dissemination patterns of antifungal-resistant human pathogenic yeast.

Risk Assessment for Children Exposed to Beach Sands Impacted by Oil Spill Chemicals

Due to changes in the drilling industry, oil spills are impacting large expanses of coastlines, thereby increasing the potential for people to come in contact with oil spill chemicals. The objective of this manuscript was to evaluate the health risk to children who potentially contact beach sands impacted by oil spill chemicals from the Deepwater Horizon disaster. To identify chemicals of concern, the U.S. Environmental Protection Agency’s (EPA’s) monitoring data collected during and immediately after the spill were evaluated. This dataset was supplemented with measurements from beach sands and tar balls collected five years after the spill. Of interest is that metals in the sediments were observed at similar levels between the two sampling periods; some differences were observed for metals levels in tar balls. Although PAHs were not observed five years later, there is evidence of weathered-oil oxidative by-products. Comparing chemical concentration data to baseline soil risk levels, three metals (As, Ba, and V) and four PAHs (benzo[a]pyrene, benz[a]anthracene, benzo[b]fluoranthene, and dibenz[a,h]anthracene) were found to exceed guideline levels prompting a risk assessment. For acute or sub-chronic exposures, hazard quotients, computed by estimating average expected contact behavior, showed no adverse potential health effects. For cancer, computations using 95% upper confidence limits for contaminant concentrations showed extremely low increased risk in the 10⁻⁶ range for oral and dermal exposure from arsenic in sediments and from dermal exposure from benzo[a]pyrene and benz[a]anthracene in weathered oil. Overall, results suggest that health risks are extremely low, given the limitations of available data. Limitations of this study are associated with the lack of toxicological data for dispersants and oil-spill degradation products. We also recommend studies to collect quantitative information about children’s beach play habits, which are necessary to more accurately assess exposure scenarios and health risks.

Regional Similarities and Consistent Patterns of Local Variation in Beach Sand Bacterial Communities throughout the Northern Hemisphere

Recent characterization of the bacterial community structure in beach sands has revealed patterns of biogeography similar to those observed in aquatic environments. Studies to date, however, have mainly focused on subtidal sediments from marine beaches. Here, we investigate the bacterial diversity, using Illumina-based sequencing of the V5-V6 region of the 16S rRNA gene, at 11 beaches representing those next to the Great Lakes, Florida, and the Pacific Ocean. The alpha diversity differed significantly among regions (P< 0.0001), while the within-region diversity was more similar. The beta diversity also differed by region (P< 0.001), where freshwater sands had significantly higher abundances of taxa within the Actinobacteria, Betaproteobacteria, and Verrucomicrobia than marine environments. In contrast, marine sands harbored greater abundances of Gamma proteobacteria and Planctomycetes, and those from Florida had more Delta proteobacteria and Firmicutes Marine beaches had significantly different phylogenetic community structures (P ≤ 0.018), but freshwater and Florida beaches showed fewer within-region phylogenetic differences. Furthermore, regionally distinct patterns in taxonomic variation were observed in backshore sands, which had communities distinct from those in nearshore sands (P< 0.001). Sample depth minimally influenced the community composition. The results of this study reveal distinct bacterial community structures in sand on a broad geographic scale but moderate regional similarity and suggest that local variation is primarily related to the distance from the shoreline. This study offers a novel comparison of the bacterial communities in freshwater and marine beach sands and provides an important basis for future comparisons and analyses to elucidate factors affecting microbial ecology in this underexplored environment.

IMPORTANCE

This study presents a large-scale geographic characterization of the bacterial communities present in beach sands. While previous studies have evaluated how environmental factors influence bacterial community composition, few have evaluated bacterial communities in freshwater sands. Furthermore, the use of a consistent methodology to characterize bacterial communities here allowed a novel comparison of communities across geographic regions. We reveal that while the community composition in sands at individual beaches is distinct, beach sands within the same region harbor similar assemblages of bacteria and these assemblages differ greatly between regions. In addition, moisture, associated with distance from the shoreline, strongly influences the bacteria present in sands and more strongly influences the bacteria present than sample depth does. Thus, the data presented here offer an important basis for a broader characterization of the ecology of bacteria in sands, which may also be relevant to public health and resource management initiatives.

Evaluation of the distribution of fecal indicator bacteria in a river system depending on different types of land use in the southern watershed of the Baltic Sea

The aim of the study was to determine the effects of land use management on changes in the fecal contamination of water in the Łyna River, one of the main lowland watercourses in the southern watershed of the Baltic Sea (northern Poland). A total of 120 water samples were collected in different seasons of 2011 and 2012 at 15 sites where the river intersected forest (FA), agricultural (AA), and urbanized (UA) areas. Fecal indicator bacteria (FIB), the counts of Enterobacteriaceae and Escherichia coli, total bacterial counts (TBCs), and domain Bacteria (EUB338) were determined by culture-dependent and culture-independent methods. Temperature, pH, chemical oxygen demand, dissolved oxygen, total dissolved solids, ammonia nitrogen, nitrite nitrogen, nitrate nitrogen, orthophosphate, and total phosphorus were also determined. The lowest bacterial counts were noted in water samples collected in FA, and the highest in samples collected in UA. Statistically significant differences were determined between bacterial populations across the analyzed land use types and in different sampling seasons. Significant correlations were also observed between the populations of FIB and physicochemical parameters. The results indicate that land use type influenced FIB concentrations in river water. The combined use of conventional and molecular methods improves the accuracy of fecal contamination analyses in river ecosystems.

U.S. Recreational Water Quality Criteria: A Vision for the Future

This manuscript evaluates the U.S. Recreational Water Quality Criteria (RWQC) of 2012, based upon discussions during a conference held 11-13 March 2013, in Honolulu, Hawaii. The RWQC of 2012 did not meet expectations among the research community because key recommended studies were not completed, new data to assess risks to bathers exposed to non-point sources of fecal indicator bacteria (FIB) were not developed, and the 2012 RWQC did not show marked improvements in strategies for assessing health risks for bathers using all types of recreational waters. The development of the 2012 RWQC was limited in scope because the epidemiologic studies at beach sites were restricted to beaches with point sources of pollution and water samples were monitored for only enterococci. The vision for the future is development of effective RWQC guidelines based on epidemiologic and quantitative microbial risk assessment (QMRA) studies for sewage specific markers, as well as human enteric pathogens so that health risks for bathers at all recreational waters can be determined. The 2012 RWQC introduced a program for states and tribes to develop site-specific water quality criteria, and in theory this approach can be used to address the limitations associated with the measurements of the traditional FIB.

A predictive model for microbial counts on beaches where intertidal sand is the primary source

Human health protection at recreational beaches requires accurate and timely information on microbiological conditions to issue advisories. The objective of this study was to develop a new numerical mass balance model for enterococci levels on nonpoint source beaches. The significant advantage of this model is its easy implementation, and it provides a detailed description of the cross-shore distribution of enterococci that is useful for beach management purposes. The performance of the balance model was evaluated by comparing predicted exceedances of a beach advisory threshold value to field data, and to a traditional regression model. Both the balance model and regression equation predicted approximately 70% the advisories correctly at the knee depth and over 90% at the waist depth. The balance model has the advantage over the regression equation in its ability to simulate spatiotemporal variations of microbial levels, and it is recommended for making more informed management decisions.

Microbial evaluation of sandboxes located in urban area

This paper presents the results of a study on the degree of bacteriological pollution of sandboxes situated in fenced and unfenced housing estates located in an urban area in Olsztyn, Poland. Heterotrophic plate counts (HPC22, HPC37), Enterobacteriaceae, Escherichia coli, Enterococcus spp., Staphylococcus spp. and Clostridium perfringens determined by cultivation and fluorescence in situ hybridization (FISH) methods were used as indicators of the sanitary state. Their maximum number in the sand samples reached values of up to 5.4×10(7), 2.6×10(6), 3.3×10(4), 2.1×10(3), 1.8×10(4), 1.9×10(1) and 1.2×10(4)CFU/g, respectively. It was found that values of culture-independent method were two-four orders greater than those obtained by the cultivation method. Among identified Enterobacteriaceae, Pantoea spp. and Enterobacter cloacae were the most numerous, whereas Escherichia cells were detected only occasionally. Pathogenic bacteria of the genus Salmonella sp. were isolated from sandboxes also when E. coli were absent. Bacteria from Staphylococcus genus were isolated irrespective of the site and time of sampling. Additionally, the presence of molds and yeasts was studied. Maximum counts of these microorganisms amounted to 1.0×10(5) and to 3.5×10(4)CFU/g. Aspergillus, Penicillium, Alternaria and Trichoderma genera were most numerous among molds, whereas Trichosporon was detected most frequently among yeasts. Sandboxes in the fenced housing estate and those located in the area which is not close to trees were less polluted than the sand collected from sandboxes in the unfenced housing estate. Potentially pathogenic bacteria of the genus Salmonella spp. were identified in analyzed sandboxes, also when Toxocara and E. coli were absent. It seems that assessing the contamination of children's play areas basing only on fecal bacteria counts and by monitoring number of parasites' eggs may be insufficient to evaluate microbial pollution of sandboxes and may not fully reflect their safety for children.

Microbes in Beach Sands: Integrating Environment, Ecology and Public Health

Beach sand is a habitat that supports many microbes, including viruses, bacteria, fungi and protozoa (micropsammon). The apparently inhospitable conditions of beach sand environments belie the thriving communities found there. Physical factors, such as water availability and protection from insolation; biological factors, such as competition, predation, and biofilm formation; and nutrient availability all contribute to the characteristics of the micropsammon. Sand microbial communities include autochthonous species/phylotypes indigenous to the environment. Allochthonous microbes, including fecal indicator bacteria (FIB) and waterborne pathogens, are deposited via waves, runoff, air, or animals. The fate of these microbes ranges from death, to transient persistence and/or replication, to establishment of thriving populations (naturalization) and integration in the autochthonous community. Transport of the micropsammon within the habitat occurs both horizontally across the beach, and vertically from the sand surface and ground water table, as well as at various scales including interstitial flow within sand pores, sediment transport for particle-associated microbes, and the large-scale processes of wave action and terrestrial runoff. The concept of beach sand as a microbial habitat and reservoir of FIB and pathogens has begun to influence our thinking about human health effects associated with sand exposure and recreational water use. A variety of pathogens have been reported from beach sands, and recent epidemiology studies have found some evidence of health risks associated with sand exposure. Persistent or replicating populations of FIB and enteric pathogens have consequences for watershed/beach management strategies and regulatory standards for safe beaches. This review summarizes our understanding of the community structure, ecology, fate, transport, and public health implications of microbes in beach sand. It concludes with recommendations for future work in this vastly under-studied area.

Decay of genetic markers for fecal bacterial indicators and pathogens in sand from Lake Superior

Beach sands impact water quality and pathogen loads, however, the comparative decay of the fecal indicator bacteria (FIB) Enterococcus spp. and Escherichia coli, and pathogens in freshwater sand have not been examined. In this study, freshwater sand microcosms were inoculated with sewage and pure cultures of bacterial pathogens to compare relative decay rates. The abundance of culturable Enterococcus spp. and E. coli, genetic markers for Enterococcus spp. (Entero1), total Bacteroides (AllBac), and human-specific Bacteroides (HF183), and genetic markers for the pathogens Campylobacter jejuni, methicillin-resistant Staphylococcus aureus (MRSA), Salmonella enterica subsp. enterica serovar Typhimurium, and Shigella flexneri were monitored over the course of two weeks using conventional culture methods and quantitative PCR (qPCR). The effect of moisture on the persistence of culturable FIB and all genetic markers was also determined. In addition, propidium monoazide (PMA) treatment was used to examine differences in the persistence of total genetic markers and those from live cells. Decay rates were statistically compared using Tukey's test. Moisture had a significant (p ≤ 0.05) effect on the decay rates of culturable indicator bacteria, total AllBac markers, and genetic markers for FIB, Salmonella, and MRSA from live cells. At 14% sand moisture, the decay rate of total markers was slower than that of live cells for all qPCR assays, but at 28% moisture, there was no difference in the decay rates of total and live markers for any assay. AllBac and MRSA markers increased in sand at 28% moisture, probably indicating cellular growth. Overall, culturable FIB and HF183 had decay rates that were most comparable to the bacterial pathogen markers examined in this study, whereas Entero1 and AllBac rarely exhibited decay rates similar to the bacterial pathogens in this study. The choice of FIB for assessment of fecal contamination in freshwater sand should take into account the pathogen of concern and sand moisture conditions.

Routine screening of harmful microorganisms in beach sands: implications to public health

Beaches worldwide provide recreational opportunities to hundreds of millions of people and serve as important components of coastal economies. Beach water is often monitored for microbiological quality to detect the presence of indicators of human sewage contamination so as to prevent public health outbreaks associated with water contact. However, growing evidence suggests that beach sand can harbor microbes harmful to human health, often in concentrations greater than the beach water. Currently, there are no standards for monitoring, sampling, analyzing, or managing beach sand quality. In addition to indicator microbes, growing evidence has identified pathogenic bacteria, viruses, and fungi in a variety of beach sands worldwide. The public health threat associated with these populations through direct and indirect contact is unknown because so little research has been conducted relating to health outcomes associated with sand quality. In this manuscript, we present the consensus findings of a workshop of experts convened in Lisbon, Portugal to discuss the current state of knowledge on beach sand microbiological quality and to develop suggestions for standardizing the evaluation of sand at coastal beaches. The expert group at the "Microareias 2012" workshop recommends that 1) beach sand should be screened for a variety of pathogens harmful to human health, and sand monitoring should then be initiated alongside regular water monitoring; 2) sampling and analysis protocols should be standardized to allow proper comparisons among beach locations; and 3) further studies are needed to estimate human health risk with exposure to contaminated beach sand. Much of the manuscript is focused on research specific to Portugal, but similar results have been found elsewhere, and the findings have worldwide implications.

Microbial release from seeded beach sediments during wave conditions

Beach sands can sustain indigenous and introduced populations of enterococci. The objective of this study was to evaluate wave action in promoting the release of introduced bacteria. To accomplish this objective this study developed a method to assess attachment and identified conditions under which introduced bacteria are integrated into the sand. A new "shearing assay" showed that attachment of the introduced spike mimicked that of the natural sand when the spike was allowed to integrate into the sand for 24h at room temperature at a sand moisture content of 20%. Experiments in a wave flume showed that waves were capable of releasing about 60% of the total bacteria added. This suggests that for the range of wave conditions evaluated (height: 1.9-10.5 cm, period:1-2.7s), waves were incapable of releasing all of the bacteria. Further study is needed to evaluate bacteria attachment mechanisms.