Chlorine and Monochloramine Disinfection of Legionella pneumophila Colonizing Copper and Polyvinyl Chloride Drinking Water Biofilms

A review of research advances on disinfection strategies for biofilm control in drinking water distribution systems

The presence of biofilms in drinking water distribution systems (DWDS) is responsible for water quality deterioration and a possible source of public health risks. Different factors impact the biological stability of drinking water (DW) in the distribution networks, such as the presence and concentration of nutrients, water temperature, pipe material composition, hydrodynamic conditions, and levels of disinfectant residual. This review aimed to evaluate the current state of knowledge on strategies for DW biofilm disinfection through a qualitative and quantitative analysis of the literature published over the last decade. A systematic review method was performed on the 562 journal articles identified through database searching on Web of Science and Scopus, with 85 studies selected for detailed analysis. A variety of disinfectants were identified for DW biofilm control such as chlorine, chloramine, UV irradiation, hydrogen peroxide, chlorine dioxide, ozone, and others at a lower frequency, namely, electrolyzed water, bacteriophages, silver ions, and nanoparticles. The disinfectants can impact the microbial communities within biofilms, reduce the number of culturable cells and biofilm biomass, as well as interfere with the biofilm matrix components. The maintenance of an effective residual concentration in the water guarantees long-term prevention of biofilm formation and improves the inactivation of detached biofilm-associated opportunistic pathogens. Additionally, strategies based on multi-barrier processes by optimization of primary and secondary disinfection combined with other water treatment methods improve the control of opportunistic pathogens, reduce the chlorine-tolerance of biofilm-embedded cells, as well as decrease the corrosion rate in metal-based pipelines. Most of the studies used benchtop laboratory devices for biofilm research. Even though these devices mimic the conditions found in real DWDS, future investigations on strategies for DW biofilm control should include the validity of the promising strategies against biofilms formed in real DW networks.

Responses of drinking water bulk and biofilm microbiota to elevated water age in bench-scale simulated distribution systems

Reductions in nonresidential water demand during the COVID-19 pandemic highlighted the importance of understanding how water age impacts drinking water quality and microbiota in piped distribution systems. Using benchtop model distribution systems, we aimed to characterize the impacts of elevated water age on microbiota in bulk water and pipe wall biofilms. Five replicate constant-flow reactors were fed with municipal chloraminated tap water for 6 months prior to building closures and 7 months after. After building closures, chloramine levels entering the reactors dropped; in the reactor bulk water and biofilms the mean cell counts and ATP concentrations increased over an order of magnitude while the detection of opportunistic pathogens remained low. Water age, and the corresponding physicochemical changes, strongly influenced microbial abundance and community composition. Differential initial microbial colonization also had a lasting influence on microbial communities in each reactor (i.e., historical contingency).

Composition of active bacterial communities and presence of opportunistic pathogens in disinfected and non-disinfected drinking water distribution systems in Finland

Many factors, including microbiome structure and activity in the drinking water distribution system (DWDS), affect the colonization potential of opportunistic pathogens. The present study aims to describe the dynamics of active bacterial communities in DWDS and identify the factors that shape the community structures and activity in the selected DWDSs. Large-volume drinking water and hot water, biofilm, and water meter deposit samples were collected from five DWDSs. Total nucleic acids were extracted, and RNA was further purified and transcribed into its cDNA from a total of 181 water and biofilm samples originating from the DWDS of two surface water supplies (disinfected with UV and chlorine), two artificially recharged groundwater supplies (non-disinfected), and a groundwater supply (disinfected with UV and chlorine). In chlorinated DWDSs, concentrations of <0.02-0.97 mg/l free chlorine were measured. Bacterial communities in the RNA and DNA fractions were analysed using Illumina MiSeq sequencing with primer pair 341F-785R targeted to the 16S rRNA gene. The sequence libraries were analysed using QIIME pipeline, Program R, and MicrobiomeAnalyst. Not all bacterial cells were active based on their 16S rRNA content, and species richness was lower in the RNA fraction (Chao1 mean value 490) than in the DNA fraction (710). Species richness was higher in the two DWDSs distributing non-disinfected artificial groundwater (Chao1 mean values of 990 and 1 000) as compared to the two disinfected DWDSs using surface water (Chao1 mean values 190 and 460) and disinfected DWDS using ground water as source water (170). The difference in community structures between non-disinfected and disinfected water was clear in the beta-diversity analysis. Distance from the waterworks also affected the beta diversity of community structures, especially in disinfected distribution systems. The two most abundant bacteria in the active part of the community (RNA) and total bacterial community (DNA) belonged to the classes Alphaproteobacteria (RNA 28 %, DNA 44 %) and Gammaproteobacteria (RNA 32 %, DNA 30 %). The third most abundant and active bacteria class was Vampirovibrionia (RNA 15 %), whereas in the total community it was Paceibacteria (DNA 11 %). Class Nitrospiria was more abundant and active in both cold and hot water in DWDS that used chloramine disinfection compared to non-chlorinated or chlorine-using DWDSs. Thirty-eight operational taxonomic units (OTU) of Legionella, 30 of Mycobacterium, and 10 of Pseudomonas were detected among the sequences. The (RT)-qPCR confirmed the presence of opportunistic pathogens in the DWDSs studied as Legionella spp. was detected in 85 % (mean value 4.5 × 104 gene copies/100 ml), Mycobacterium spp. in 95 % (mean value 8.3 × 106 gene copies/100 ml), and Pseudomonas spp. in 78 % (mean value 1.6 × 105 gene copies/100 ml) of the water and biofilm samples. Sampling point inside the system (distance from the waterworks and cold/hot system) affected the active bacterial community composition. Chloramine as a chlorination method resulted in a recognizable community composition, with high abundance of bacteria that benefit from the excess presence of nitrogen. The results presented here confirm that each DWDS is unique and that opportunistic pathogens are present even in conditions when water quality is considered excellent.

Effectiveness of monochloramine for inactivation of coronavirus in reclaimed water

Fecal shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by infected persons into wastewater was documented early during the COVID-19 pandemic, thereby stimulating inquiries into the effectiveness of municipal wastewater treatment processes for the reduction of infectious viruses. In wastewater treatment plants, free chlorine has traditionally been the disinfectant utilized due to its low cost and high efficacy. However, regulations limiting disinfection by-products have prompted a shift to chloramination in many areas of the United States. While studies regarding the effectiveness of free chlorine against many viral agents are abundant, the efficacy of monochloramine (NH2Cl) has been less well researched. This study aimed to determine the effectiveness of pre-formed monochloramine for disinfection of human coronavirus 229E (HCoV-229E) in both phosphate-buffered saline (PBS) and reclaimed water from a water reclamation plant in Tucson, Arizona. Reclaimed water was sampled over the course of six months (August 2020 to November 2020), and dosed with monochloramine at 3 mg/L. An additional 1 mg/L free ammonia was added to simulate the operational conditions of the treatment plant. Viability was determined using MRC-5 host cell monolayers, using the TCID50 assay method. An average Ct99.9 (concentration of disinfectant multiplied by the contact time to achieve a 99.9 % reduction of the target organism) of 176 mg*min/L monochloramine was determined. No significant difference in inactivation rate was observed between the dosed reclaimed water and phosphate buffered saline (PBS). These data indicate that monochloramine is an effective disinfectant for coronaviruses. They also indicate that the water matrix type did not significantly impact the disinfection efficacy of monochloramine against HCoV-229E in reclaimed wastewater compared to PBS.

Niche Differentiation of Biofilm Microorganisms in a Full-scale Municipal Drinking Water Distribution System in China and Their Implication for Biofilm Control

Biofilms on the inner surface of a drinking water distribution system (DWDS) affect water quality and stability. Understanding the niche differentiation of biofilm microbial communities is necessary for the efficient control of DWDS biofilms. However, biofilm studies are difficult to conduct in the actual DWDS because of inaccessibility to the pipes buried underground. Taking the opportunity of infrastructure construction and relevant pipeline replacement in China, biofilms in a DWDS (a water main and its branch pipes) were collected in situ, followed by analysis on the abundances and community structures of bacterial and archaeal using quantitative PCR and high-throughput sequencing, respectively. Results showed that archaea were detected only in the biofilms of the water main, with a range of 9.4×103~1.1×105 copies/cm2. By contrast, bacteria were detected in the biofilms of branch pipes and the distal part of the water main, with a range of 8.8×103~9.6×106 copies/cm2. Among the biofilm samples, the archaeal community in the central part of the water main showed the highest richness and diversity. Nitrosopumilus was found to be predominant (86.22%) in the biofilms of the proximal part of the water main. However, Methanobrevibacter (87.15%) predominated in the distal part of the water main. The bacterial community of the water main and branch pipes was primarily composed of Firmicutes and Proteobacteria at the phylum level, respectively. Regardless of archaea or bacteria, only few operational taxonomic units (OTUs) (<0.5% of total OTUs) were shared by all the biofilms, indicating the niche differentiation of biofilm microorganisms. Moreover, the high Mn content in the biofilms of the distal sampling location (D3) in the water main was linked to the predominance of Bacillus. Functional gene prediction revealed that the proportion of infectious disease-related genes was 0.44-0.67% in the tested biofilms. Furthermore, functional genes related to the resistance of the bacterial community to disinfections and antibiotics were detected in all the samples, that is, glutathione metabolism-relating genes (0.14-0.65%) and beta-lactam resistance gene (0.01-0.05%). The results of this study indicate the ubiquity of archaea and bacteria in the biofilms of water main and branch pipes, respectively, and pipe diameters could be a major influencing factor on bacterial community structure. In the water main, the key finding was the predominant existence of archaea, particularly Nitrosopumilus and methanogen. Hence, their routine monitoring and probable influences on water quality in pipelines with large diameter should be given more attention. Besides, since Mn-related Bacillus and suspected pathogenic Enterococcus were detected in the biofilm, supplementation of disinfectant may be a feasible strategy for inhibiting their growth and ensuring water quality. In addition, the monitoring on their abundance variation could help to determine the frequency and methods of pipeline maintenance.

Shotgun Metagenomics Reveals Impacts of Copper and Water Heater Anodes on Pathogens and Microbiomes in Hot Water Plumbing Systems

Hot water building plumbing systems are vulnerable to the proliferation of opportunistic pathogens (OPs), including Legionella pneumophila and Mycobacterium avium. Implementation of copper as a disinfectant could help reduce OPs, but a mechanistic understanding of the effects on the microbial community under real-world plumbing conditions is lacking. Here, we carried out a controlled pilot-scale study of hot water systems and applied shotgun metagenomic sequencing to examine the effects of copper dose (0-2 mg/L), orthophosphate corrosion control agent, and water heater anode materials (aluminum vs magnesium vs powered anode) on the bulk water and biofilm microbiome composition. Metagenomic analysis revealed that, even though a copper dose of 1.2 mg/L was required to reduce Legionella and Mycobacterium numbers, lower doses (e.g., ≤0.6 mg/L) measurably impacted the broader microbial community, indicating that the OP strains colonizing these systems were highly copper tolerant. Orthophosphate addition reduced bioavailability of copper, both to OPs and to the broader microbiome. Functional gene analysis indicated that both membrane damage and interruption of nucleic acid replication are likely at play in copper inactivation mechanisms. This study identifies key factors (e.g., orthophosphate, copper resistance, and anode materials) that can confound the efficacy of copper for controlling OPs in hot water plumbing.

A Critical Review on the Factors that Influence Opportunistic Premise Plumbing Pathogens: From Building Entry to Fixtures in Residences

Residential buildings provide unique conditions for opportunistic premise plumbing pathogen (OPPP) exposure via aerosolized water droplets produced by showerheads, faucets, and tubs. The objective of this review was to critically evaluate the existing literature that assessed the impact of potentially enhancing conditions to OPPP occurrence associated with residential plumbing and to point out knowledge gaps. Comprehensive studies on the topic were found to be lacking. Major knowledge gaps identified include the assessment of OPPP growth in the residential plumbing, from building entry to fixtures, and evaluation of the extent of the impact of typical residential plumbing design (e.g., trunk and branch and manifold), components (e.g., valves and fixtures), water heater types and temperature setting of operation, and common pipe materials (copper, PEX, and PVC/CPVC). In addition, impacts of the current plumbing code requirements on OPPP responses have not been assessed by any study and a lack of guidelines for OPPP risk management in residences was identified. Finally, the research required to expand knowledge on OPPP amplification in residences was discussed.

Legionella pneumophila Risk from Air–Water Cooling Units Regarding Pipe Material and Type of Water

Legionellosis is a respiratory disease related to environmental health. There have been manifold studies of pipe materials, risk installations and legionellosis without considering the type of transferred water. The objective of this study was to determine the potential development of the causative agent Legionella pneumophila regarding air–water cooling units, legislative compliance, pipe material and type of water. Forty-four hotel units in Andalusia (Spain) were analysed with respect to compliance with Spanish health legislation for the prevention of legionellosis. The chi-square test was used to explain the relationship between material–water and legislative compliance, and a biplot of the first two factors was generated. Multiple correspondence analysis (MCA) was performed on the type of equipment, legislative compliance, pipe material and type of water, and graphs of cases were constructed by adding confidence ellipses by categories of the variables. Pipe material–type of water (p value = 0.29; p < 0.05) and legislative compliance were not associated (p value = 0.15; p < 0.05). Iron, stainless steel, and recycled and well water contributed the most to the biplot. MCA showed a global pattern in which lead, iron and polyethylene were well represented. Confidence ellipses around categories indicated significant differences among categories. Compliance with Spanish health legislation regarding the prevention and control of legionellosis linked to pipe material and type of water was not observed.

The protective role and mechanism of melanin for Aspergillus niger and Aspergillus flavus against chlorine-based disinfectants

Melanin is a critical component of fungal cell wall which protect fungi from adverse environmental tress. However, the role of melanin for fungi during the disinfection with chlorine-based disinfectants has not been elucidated. The results showed that the inactivation rate constants of Aspergillus niger with chlorine and chlorine dioxide decreased from 0.08 to 2.10 min^-1 to 0 after addition of 0.32 mg/L melanin. The results indicated addition of extracted fungal melanin inhibited the inactivation efficiency of chlorine and chlorine dioxide. In contrast, the k of Aspergillus niger after inactivation with monochloramine ranged from 1.50 to 1.78 min^-1 after addition of melanin which indicated effect of melanin on the inactivation efficiency of monochloramine was negligible. In addition, the extracted fungal melanin exhibited high reactivity with chlorine and chlorine dioxide but very low reactivity with monochloramine. The different inactivation mechanisms of chlorine-based disinfectants and different reactivity of melanin with chlorine-based disinfectants led to the different protective mechanism of melanin for A. niger and A. flavus spores against disinfection with chlorine-based disinfectants. The chlorine and chlorine dioxide appeared to react with functional groups of melanin in cell wall of spores, so sacrificial reactions between melanin and disinfectants decreased the available disinfectants and limited the diffusion of disinfectants to the reactive site on cell membrane, which led to the decrease of the disinfection efficiency for chlorine and chlorine dioxide. The monochloramine could penetrate into cell and damage DNA without the effect of melanin due to its strong penetration and low reactivity with melanin. Our results systematically demonstrate the protective roles of melanin on the fungal spores against chlorine-based disinfectants and the underlying mechanisms in resisting the environmental stress caused by chlorine-based disinfectants, which provides important implications for the control of fungi, especially for fungi producing melanin.

Tenets of a holistic approach to drinking water-associated pathogen research, management, and communication

In recent years, drinking water-associated pathogens that can cause infections in immunocompromised or otherwise susceptible individuals (henceforth referred to as DWPI), sometimes referred to as opportunistic pathogens or opportunistic premise plumbing pathogens, have received considerable attention. DWPI research has largely been conducted by experts focusing on specific microorganisms or within silos of expertise. The resulting mitigation approaches optimized for a single microorganism may have unintended consequences and trade-offs for other DWPI or other interests (e.g., energy costs and conservation). For example, the ecological and epidemiological issues characteristic of Legionella pneumophila diverge from those relevant for Mycobacterium avium and other nontuberculous mycobacteria. Recent advances in understanding DWPI as part of a complex microbial ecosystem inhabiting drinking water systems continues to reveal additional challenges: namely, how can all microorganisms of concern be managed simultaneously? In order to protect public health, we must take a more holistic approach in all aspects of the field, including basic research, monitoring methods, risk-based mitigation techniques, and policy. A holistic approach will (i) target multiple microorganisms simultaneously, (ii) involve experts across several disciplines, and (iii) communicate results across disciplines and more broadly, proactively addressing source water-to-customer system management.

Differences in UV-C LED Inactivation of Legionella pneumophila Serogroups in Drinking Water

Legionella pneumophila (Lp) is an opportunistic pathogen that causes respiratory infections primarily through inhalation of contaminated aerosols. Lp can colonize premise plumbing systems due to favorable growth conditions (e.g., lower disinfectant residual, stagnation, warm temperatures). UV-C light-emitting diodes (UV-C LEDs) are an emerging water treatment technology and have been shown to effectively inactivate waterborne pathogens. In this study, the inactivation of four Lp strains (three clinical sg1, 4, and 6; and one sg1 drinking water (DW) isolate) was evaluated using a UV-C LED collimated beam at three wavelengths (255, 265, and 280 nm) and six fluence rates (0.5–34 mJ/cm²). Exposure to 255 nm resulted in higher log reductions at the lower fluences compared to exposures at 265 and 280 nm. Efficacy testing was also performed using a UV-C LED point-of-entry (POE) flow-through device. Based on the log inactivation curves, at 255 nm, the sg4 and sg6 clinical isolates were more susceptible to inactivation compared to the two sg1 isolates. However, at 265 and 280 nm, the sg1 and sg4 clinical isolates were more resistant to inactivation compared to the sg6 clinical and sg1 DW isolates. Differential log reductions were also observed using the POE device. Results indicate that although UV-C LED disinfection is effective, variations in Lp inactivation, wavelengths, and technology applications should be considered, especially when targeting specific isolates within premise plumbing systems.

Role of biofilms in the survival of Legionella pneumophila to sodium chloride treatment

Background and Objectives

Legionnaires' disease continues to be a public health concern. Colonized water distribution systems are often implicated in Legionella transmission, despite the use of various disinfection strategies, the bacterium is capable to persist and survive in water systems. The aim of this study was to investigate the persistence of Legionella pneumophila to sodium chloride over time at different temperatures and analysing the role of biofilms in the survival of this bacteria.

Materials and Methods

L. pneumophila serogroup 1 and L. pneumophila serogroup 2-15 were used to study the effect of sodium chloride on planktonic and sessile cells. The tested concentrations were: 0.5%, 1%, 2%, 3%, 4%, 6% and 8% (W/V) NaCl. Biofilms were grown on 24-well microplates.

Results

At 20°C, L. pneumophila planktonic cells were able to survive in sodium chloride concentrations up to 2%. However, at 37°C, a sodium chloride concentration over 1.5%, reduced systematically the numbers of bacterial cells. Biofilms were grown for 20 days in the absence and presence of sodium chloride. The results show that bacterial strains were able to survive and regrow after the sodium chloride shock (2-3%). Moreover, it seems that this effect is less expressed with the age of the biofilm; old biofilms were more persistent than the young ones.

Conclusion

Results from this study demonstrate that the sodium chloride disinfection strategy was effective on Legionella pneumophila planktonic cells but not on biofilms, which demonstrate the role of biofilms in the persistence and recolonization of L. pneumophila in water distribution systems.

Quantification of Legionella pneumophila by qPCR and culture in tap water with different concentrations of residual disinfectants and heterotrophic bacteria

Legionellosis prevalence is increasing in the United States. This disease is caused primarily by the bacterium Legionella pneumophila found in water and transmitted by aerosol inhalation. This pathogen has a slow growth rate and can "hide" in amoeba, making it difficult to monitor by the traditional culture method on selective media. Tap water samples (n = 358) collected across the United States were tested for L. pneumophila by both culture and quantitative Polymerase Chain Reaction (qPCR). The presence of other bacteria was quantified by heterotrophic plate counts (HPC). Residual disinfectant concentrations (free chlorine or monochloramine) were measured in all samples. Legionella pneumophila had the highest prevalence and concentration in the chlorinated water samples that had a free‑chlorine value of less than 0.2 mg Cl₂/L. In total, 24% (87/358) of the samples were positive for L. pneumophila either by qPCR or 3% (11/358) were positive by culture. In chloramine-treated samples, L. pneumophila was detected by qPCR in 21% (31/148) and 1% (2/148) by culture, despite a high monochloramine residual >1 mg Cl₂/L. Despite the presence of a high disinfectant residual (>1 mg Cl₂/L), HPC counts were substantial. This study indicates that both culture and qPCR methods have limitations when predicting a potential risk for disease associated with L. pneumophila in tap water. Measuring disinfectant residuals and quantifying HPC in water samples may be useful adjunct parameters for reducing Legionellosis' risk from public water supplies at high-risk locations.

Interplay of Biologically Active Carbon Filtration and Chlorine-Based Disinfection in Mitigating the Dissemination of Antibiotic Resistance Genes in Water Reuse Distribution Systems

Appropriate management approaches are needed to minimize the proliferation of antibiotic resistance genes (ARGs) in reclaimed water distribution systems (RWDSs). Six laboratory-scale RWDSs were operated over 3 years receiving influent with or without biologically active carbon (BAC) filtration + chlorination, chloramination, or no disinfectant residual. Shotgun metagenomic sequencing was applied toward comprehensive characterization of resistomes, focusing on total ARGs, ARG mobility, and specific ARGs of clinical concern. ARGs such as aadA, bacA, bla_OXA, mphE, msrE, sul1, and sul2 were found to be particularly sensitive to varying RWDS conditions. BAC filtration with chlorination most effectively achieved and maintained the lowest levels of nearly all metagenomically derived antibiotic resistance indicators. However, BAC filtration or addition of residual disinfectants alone tended to increase these indicators. Biofilm and sediment compartments harbored ARGs in disinfected systems, presenting a concern for their release to bulk water. Relative and absolute abundances of most ARGs tended to decrease with water age (up to 5 days), with notable exceptions in BAC-filtered chloraminated and no residual systems. Superchlorination of unfiltered water especially raised concerns in terms of elevation of clinically relevant and mobile ARGs. This study revealed that BAC filtration and disinfection must be carefully coordinated in order to effectively mitigate ARG dissemination via RWDSs.

The Bacterial Community Diversity of Bathroom Hot Tap Water Was Significantly Lower Than That of Cold Tap and Shower Water

Microbial drinking water quality in premise plumbing systems (PPSs) strongly affects public health. Bacterial community structure is the essential aspect of microbial water quality. Studies have elucidated the microbial community structure in cold tap water, while the microbial community structures in hot tap and shower water are poorly understood. We sampled cold tap, hot tap, and shower water from a simulated PPS monthly for 16 consecutive months and assessed the bacterial community structures in those samples via high-throughput sequencing of bacterial 16S rRNA genes. The total relative abundance of the top five most abundant phyla (Proteobacteria, Actinobacteria, Bacteroidetes, Cyanobacteria, and Firmicutes) was greater than 90% among the 24 identified phyla. The most abundant families were Burkholderiaceae, Sphingomonadaceae, unclassified Alphaproteobacteria, unclassified Corynebacteriales, and Mycobacteriaceae. A multiple linear regression suggests that the bacterial community diversity increased with water temperature and the age of the simulated PPS, decreased with total chlorine residual concentration, and had a limited seasonal variation. The bacterial community in hot tap water had significantly lower Shannon and Inverse Simpson diversity indices (p < 0.05) and thus a much lower diversity than those in cold tap and shower water. The paradoxical results (i.e., diversity increased with water temperature, but hot tap water bacterial community was less diverse) were presumably because (1) other environmental factors made hot tap water bacterial community less diverse, (2) the diversity of bacterial communities in all types of water samples increased with water temperature, and (3) the first draw samples of hot tap water could have a comparable or even lower temperature than shower water samples and the second draw samples of cold tap water. In both a three-dimensional Non-metric multidimensional scaling ordination plot and a phylogenetic dendrogram, the samples of cold tap and shower water cluster and are separate from hot tap water samples (p < 0.05). In summary, the bacterial community in hot tap water in the simulated PPS had a distinct structure from and a much lower diversity than those in cold tap and shower water.

Environmental Management of Legionella in Domestic Water Systems: Consolidated and Innovative Approaches for Disinfection Methods and Risk Assessment

Legionella is able to remain in water as free-living planktonic bacteria or to grow within biofilms that adhere to the pipes. It is also able to enter amoebas or to switch into a viable but not culturable (VBNC) state, which contributes to its resistance to harsh conditions and hinders its detection in water. Factors regulating Legionella growth, such as environmental conditions, type and concentration of available organic and inorganic nutrients, presence of protozoa, spatial location of microorganisms, metal plumbing components, and associated corrosion products are important for Legionella survival and growth. Finally, water treatment and distribution conditions may affect each of these factors. A deeper comprehension of Legionella interactions in water distribution systems with the environmental conditions is needed for better control of the colonization. To this purpose, the implementation of water management plans is the main prevention measure against Legionella. A water management program requires coordination among building managers, health care providers, and Public Health professionals. The review reports a comprehensive view of the state of the art and the promising perspectives of both monitoring and disinfection methods against Legionella in water, focusing on the main current challenges concerning the Public Health sector.

Water Sampling Module for Collecting and Concentrating Legionella pneumophila from Low-to-Medium Contaminated Environment

The detection of water contamination with Legionella pneumophila is of critical importance to manufacturers of water processing equipment and public health entities dealing with water networks and distribution systems. Detection methods based on polymerase chain reaction or biosensor technologies require preconcentration steps to achieve attractive sensitivity levels. Preconcentration must also be included in protocols of automated collection of water samples by systems designed for quasi-continuous monitoring of remotely located water reservoirs for the presence of L. pneumophila. We designed and characterized a water sampling module for filtration and backwashing intended for analysis of low-to-medium contaminated water, typically with L. pneumophila bacteria not exceeding 50 colony-forming units per milliliter. The concentration factors of 10× and 21× were achieved with 0.22 and 0.45 µm filters, respectively, for samples of bacteria prepared in clean saline solutions. However, a 5× concentration factor was achieved with 0.45 µm filters for a heavily contaminated or turbid water typical of some industrial water samples.

Global bibliometric meta-analytic assessment of research trends on microbial chlorine resistance in drinking water/water treatment systems

Chlorine is the commonest and cheapest disinfectant used in drinking water and wastewater treatment at household, municipal and industrial levels. However, the uprising of microbial chlorine resistance (MCR) pose critical public health hazard concerns; because, its potentiate exposure to difficult-to-treat resistant pathogens. Therefore, this study aimed at evaluating the burden of MCR in drinking water/wastewater treatment and distribution systems (DWWTDS) via science mapping of research productivity (authors, countries, institutions), thematic conceptual framework, disciplines, research networks and associated intellectual landscape. MCR data were mined from Scopus and Web of Science based on optimized algorithms with the root key term "chlorine* resistant*'' and analysed for pre-set indicator variables. Results revealed 1127 documents from 442 journals and 1430% average growth rate (AGR) of research articles from 2017 to 2019 on MCR. Country-wise, the USA (n = 299), China (n = 119), and Japan (n = 43) ranked in the 1st, 2nd, and 3rd positions respectively, among the top participating countries in MCR research. MCR research had considerable performance in public health and sustainable concern subjects namely, Environmental Sciences & Ecology, Engineering, Microbiology, Water Resources, Biotechnology & Applied Microbiology, Food Science & Technology, Public, Environ & Occupational Health, Chemistry, Infectious Diseases, and Marine & Freshwater Biology; and with noticeable AGR in Environmental Sciences & Ecology (330%) and Infectious Diseases (130%). The study found biofilm-related thrusts (n = 90, 270% AGR) as main research hotspots on MCR. Overall, the study identified and discussed four important thematic areas of public health challenges in MCR that could promote increasing waterborne diseases due to (re)emerging pathogens, enteric viruses and dissemination in DWWTDS. In conclusion, this study provides comprehensive overview of the growing burden of MCR in DWWTDS and standout as a primer of information for researchers on MCR. It recommends direct, intentional and integrated research priorities on MCR to overcome accompanying public health and environmental threats. In addition, chlorine resistance in waterborne fungi have not received research attention. Research activities related to fungal chlorine resistance will be an invaluable future direction in DWWTDS and guide against exposure to waterborne pathogenic fungi and mycotoxins. It is unknown whether chlorine resistance can be acquired by horizontal gene transfer in microorganisms and future research should elucidate this important thrust.

Responses of bacterial communities and resistance genes on microplastics to antibiotics and heavy metals in sewage environment

In present study, copper (Cu), zinc (Zn), tetracycline (TC) and ampicillin (AMP) were selected to study the individual and synergistic effects of antibiotics and heavy metals on the microbial communities and resistance genes on polyvinyl chloride microplastics (PVC MPs) and surrounding sewage after 28 and 84 days. The results indicated that PVC MPs enriched many microorganisms from surrounding sewage, especially pathogenic bacteria such as Mycobacterium and Aquabacterium. The resistance gene with the highest abundance enriched on PVC MPs was tnpA (average abundance of 1.0 × 10⁷ copies/mL sewage). The single presence of Zn, TC and AMP inhibited these enrichments for a short period of time (28 days). But the single presence of Cu and the co-existence of antibiotics and heavy metals inhibited these enrichments for a long period of time (84 days), resulting in relatively low microbial diversities and resistance genes abundances. Transpose tnpA had significantly positive correlations (p < 0.05) with all other genes. Pathogenic bacteria Mycobacterium and Legionella were potential hosts harboring 5 and 1 resistance genes, respectively. Overall, PVC MPs played important roles in the distribution and transfer of pathogenic bacteria and resistance genes in sewage with the presence of antibiotics or (and) heavy metals.

Chasing Waterborne Pathogens in Antarctic Human-Made and Natural Environments, with Special Reference to Legionella spp

Waterborne pathogenic diseases are public health issues, especially for people staying in remote environments, such as Antarctica. After repeated detection of Legionella by PCR from the shower room of Syowa Station, the Japanese Antarctic research station, we wanted to understand the occurrence of waterborne pathogens, especially Legionella, in the station and their potential sources. In this study, we analyzed water and biofilm samples collected from the water facilities of Syowa Station, as well as water samples from surrounding glacier lakes, by 16S rRNA gene-based amplicon sequencing. For Legionella spp., we further attempted to obtain a detailed community structure by using genus-specific primers. The results showed that potentially pathogenic genera were mostly localized in the station, while Legionella spp., Pseudomonas spp., and Mycobacterium spp. were also widely distributed in lakes. Genus-specific analysis of Legionella spp. within the lake environments confirmed the presence of diverse Legionella amplicon sequence variants (ASVs) that were distinctly different from the Legionella ASVs detected in the station. The majority of the Legionella ASVs inhabiting Antarctic lake habitats were phylogenetically distinct from known Legionella species, whereas the ASVs detected in the human-made station tended to contain ASVs highly similar to well-described mesophilic species with human pathogenicity. These data suggest that unexpected Legionella diversity exists in remote Antarctic cold environments and that environmental differences (e.g., temperature) in and around the station affect the community structure.IMPORTANCE We comprehensively examined the localization of potential waterborne pathogens in the Antarctic human-made and natural aquatic environment with special focus on Legionella spp. Some potential pathogenic genera were detected with low relative abundance in the natural environment, but most detections of these genera occurred in the station. Through detailed community analysis of Legionella spp., we revealed that a variety of Legionella spp. was widely distributed in the Antarctic environment and that they were phylogenetically distinct from the described species. This fact indicates that there are still diverse unknown Legionella spp. in Antarctica, and this genus encompasses a greater variety of species in low-temperature environments than is currently known. In contrast, amplicon sequence variants closely related to known Legionella spp. with reported pathogenicity were almost solely localized in the station, suggesting that human-made environments alter the Legionella community.

Critical Review: Propensity of Premise Plumbing Pipe Materials to Enhance or Diminish Growth of Legionella and Other Opportunistic Pathogens

Growth of Legionella pneumophila and other opportunistic pathogens (OPs) in drinking water premise plumbing poses an increasing public health concern. Premise plumbing is constructed of a variety of materials, creating complex environments that vary chemically, microbiologically, spatially, and temporally in a manner likely to influence survival and growth of OPs. Here we systematically review the literature to critically examine the varied effects of common metallic (copper, iron) and plastic (PVC, cross-linked polyethylene (PEX)) pipe materials on factors influencing OP growth in drinking water, including nutrient availability, disinfectant levels, and the composition of the broader microbiome. Plastic pipes can leach organic carbon, but demonstrate a lower disinfectant demand and fewer water chemistry interactions. Iron pipes may provide OPs with nutrients directly or indirectly, exhibiting a high disinfectant demand and potential to form scales with high surface areas suitable for biofilm colonization. While copper pipes are known for their antimicrobial properties, evidence of their efficacy for OP control is inconsistent. Under some circumstances, copper's interactions with premise plumbing water chemistry and resident microbes can encourage growth of OPs. Plumbing design, configuration, and operation can be manipulated to control such interactions and health outcomes. Influences of pipe materials on OP physiology should also be considered, including the possibility of influencing virulence and antibiotic resistance. In conclusion, all known pipe materials have a potential to either stimulate or inhibit OP growth, depending on the circumstances. This review delineates some of these circumstances and informs future research and guidance towards effective deployment of pipe materials for control of OPs.

Evaluation of Legionella spp. Colonization in Residential Buildings Having Solar Thermal System for Hot Water Production

Despite an increase of literature data on Legionella spp. presence in private water systems, epidemiological reports assert a continuing high incidence of Legionnaires’ disease infection in Italy. In this study, we report a survey on Legionella spp. colonization in 58 buildings with solar thermal systems for hot water production (TB). In all buildings, Legionella spp. presence was enumerated in hot and cold water samples. Microbiological potability standards of cold water were also evaluated. Legionella spp. was detected in 40% of the buildings. Moreover, we detected correlations between the count of Legionella spp. and the presence of the optimal temperature for the microorganism growth (less than 40 °C). Our results showed that cold water was free from microbiological hazards, but Legionella spp., was detected when the mean cold water temperature was 19.1 ± 2.2 °C. This may considered close to the suboptimal value for the Legionella growth (more then 20 °C). In conclusion, we observed the presence of a Legionnaires’ disease risk and the need of some strategies aimed to reduce it, such as the application of training programs for all the workers involved in water systems maintenance.

Legionella Diversity and Spatiotemporal Variation in The Occurrence of Opportunistic Pathogens within a Large Building Water System

Understanding Legionella survival mechanisms within building water systems (BWSs) is challenging due to varying engineering, operational, and water quality characteristics unique to each system. This study aimed to evaluate Legionella, mycobacteria, and free-living amoebae occurrence within a BWS over 18-28 months at six locations differing in plumbing material and potable water age, quality, and usage. A total of 114 bulk water and 57 biofilm samples were analyzed. Legionella culturability fluctuated seasonally with most culture-positive samples being collected during the winter compared to the spring, summer, and fall months. Positive and negative correlations between Legionella and L. pneumophila occurrence and other physiochemical and microbial water quality parameters varied between location and sample types. Whole genome sequencing of 19 presumptive Legionella isolates, from four locations across three time points, identified nine isolates as L. pneumophila serogroup (sg) 1 sequence-type (ST) 1; three as L. pneumophila sg5 ST1950 and ST2037; six as L. feeleii; and one as Ochrobactrum. Results showed the presence of a diverse Legionella population with consistent and sporadic occurrence at four and two locations, respectively. Viewed collectively with similar studies, this information will enable a better understanding of the engineering, operational, and water quality parameters supporting Legionella growth within BWSs.

Influence of surface copper content on Stenotrophomonas maltophilia biofilm control using chlorine and mechanical stress

This work aimed to evaluate the action of materials with different copper content (0, 57, 96 and 100%) on biofilm formation and control by chlorination and mechanical stress. Stenotrophomonas maltophilia isolated from drinking water was used as a model microorganism and biofilms were developed in a rotating cylinder reactor using realism-based shear stress conditions. Biofilms were characterized phenotypically and exposed to three control strategies: 10 mg l^-1 of free chlorine for 10 min, an increased shear stress (a fluid velocity of 1.5 m s^-1 for 30s), and a combination of both treatments. These shock treatments were not effective in biofilm control. The benefits from the use of copper surfaces was found essentially in reducing the numbers of non-damaged cells. Copper materials demonstrated better performance in biofilm prevention than chlorine. In general, copper alloys may have a positive public health impact by reducing the number of non-damaged cells in the water delivered after chlorine exposure.

Impact of Chlorine and Chloramine on the Detection and Quantification of Legionella pneumophila and Mycobacterium Species

Potable water can be a source of transmission for legionellosis and nontuberculous mycobacterium (NTM) infections and diseases. Legionellosis is caused largely by Legionella pneumophila, specifically serogroup 1 (Sg1). Mycobacterium avium, Mycobacterium intracellulare, and Mycobacterium abscessus are three leading species associated with pulmonary NTM disease. The estimated rates of these diseases are increasing in the United States, and the cost of treatment is high. Therefore, a national assessment of water disinfection efficacy for these pathogens was needed. The disinfectant type and total chlorine residual (TClR) were investigated to understand their influence on the detection and concentrations of the five pathogens in potable water. Samples (n = 358) were collected from point-of-use taps (cold or hot) from locations across the United States served by public water utilities that disinfected with chlorine or chloramine. The bacteria were detected and quantified using specific primer and probe quantitative-PCR (qPCR) methods. The total chlorine residual was measured spectrophotometrically. Chlorine was the more potent disinfectant for controlling the three mycobacterial species. Chloramine was effective at controlling L. pneumophila and Sg1. Plotting the TClR associated with positive microbial detection showed that an upward TClR adjustment could reduce the bacterial count in chlorinated water but was not as effective for chloramine. Each species of bacteria responded differently to the disinfection type, concentration, and temperature. There was no unifying condition among the water characteristics studied that achieved microbial control for all. This information will help guide disinfectant decisions aimed at reducing occurrences of these pathogens at consumer taps and as related to the disinfectant type and TClR.IMPORTANCE The primary purpose of tap water disinfection is to control the presence of microbes. This study evaluated the role of disinfectant choice on the presence at the tap of L. pneumophila, its Sg1 serogroup, and three species of mycobacteria in tap water samples collected at points of human exposure at locations across the United States. The study demonstrates that microbial survival varies based on the microbial species, disinfectant, and TClR.

The role of surface copper content on biofilm formation by drinking water bacteria

Copper alloys demonstrated comparable or higher performance than elemental copper in biofilm control. The alloy containing 96% copper was the most promising surface in biofilm control and regrowth prevention.