Abstract
BackgroundWater and High Purity Water (HPW) distribution systems can be contaminated with human pathogenic microorganisms. This biocontamination may pose a risk to human health as HPW is commonly used in the industrial, pharmaceutical and clinical sectors. Currently, routine microbiological testing of HPW is performed using slow and labour intensive traditional microbiological based techniques. There is a need to develop a rapid culture independent methodology to quantitatively detect and identify biocontamination associated with HPW.ResultsA novel internally controlled 5-plex real-time PCR Nucleic Acid Diagnostics assay (NAD), was designed and optimised in accordance with Minimum Information for Publication of Quantitative Real-Time PCR Experiments guidelines, to rapidly detect, identify and quantify the human pathogenic bacteria Stenotrophomonas maltophilia, Burkholderia species, Pseudomonas aeruginosa and Serratia marcescens which are commonly associated with the biocontamination of water and water distribution systems. The specificity of the 5-plex assay was tested against genomic DNA isolated from a panel of 95 microorganisms with no cross reactivity observed. The analytical sensitivities of the S. maltophilia, B. cepacia, P. aeruginosa and the S. marcescens assays are 8.5, 5.7, 3.2 and 7.4 genome equivalents respectively.Subsequently, an analysis of HPW supplied by a Millipore Elix 35 water purification unit performed using standard microbiological methods revealed high levels of naturally occurring microbiological contamination. Five litre water samples from this HPW delivery system were also filtered and genomic DNA was purified directly from these filters. These DNA samples were then tested using the developed multiplex real-time PCR NAD assay and despite the high background microbiological contamination observed, both S. maltophilia and Burkholderia species were quantitatively detected and identified. At both sampling points the levels of both S. maltophilia and Burkholderia species present was above the threshold of 10 cfu/100 ml recommended by both EU and US guidelines.ConclusionsThe novel culture independent methodology described in this study allows for rapid (<5 h), quantitative detection and identification of these four human pathogens from biocontaminated water and HPW distribution systems. We propose that the described NAD assay and associated methodology could be applied to routine testing of water and HPW distribution systems to assure microbiological safety and high water quality standards.Electronic supplementary materialThe online version of this article (doi:10.1186/s12896-015-0124-1) contains supplementary material, which is available to authorized users.
Highlights
Water and High Purity Water (HPW) distribution systems can be contaminated with human pathogenic microorganisms
The efficient operation and biological control of water distribution systems is important as High Purity Water (HPW), municipal and recreational water contaminated with waterborne pathogens such as nonfastidious Gram-negative bacteria non Enterobacteriaceae (GNB-NE) can pose a serious risk to human health
There have been many reported cases of Healthcare Associated Infections (HCAIs) associated with microbial contamination of water and HPW delivery systems and exposure to these water-borne pathogens in hospitals can result in increased patient morbidity and mortality [11,12,13]
Summary
Water and High Purity Water (HPW) distribution systems can be contaminated with human pathogenic microorganisms. In particular HPW, is a vital component of both the clinical and many industrial manufacturing sectors such as the pharmaceutical, food and beverage and semiconductor industries [1,2,3] In healthcare facilities, such as neonatal units, intensive care units, dental practices and clinical diagnostics testing laboratories, water and HPW is routinely used for hand washing, bathing, cleaning semi-critical areas washing and rinsing patient medical devices and in the preparation and processing of medicines and other health products [4,5]. A recent traditional culture based microbiological study of water and water distribution systems in a number of hospital departments revealed high levels of contamination by GNB-NE [6] In such settings, this microbial contamination with opportunistic pathogens could result in the transmission of Healthcare Associated Infections (HCAIs) in immunocompromised patient groups [7,8,9,10]. Such clinical derived pseudoepidemics can result in costly additional and unnecessary diagnostic procedures and therapeutic interventions for patients [16,17,18,19]
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