Abstract
BackgroundHeat shock is a potential control strategy for Legionella pneumophila in hot water plumbing systems. However, it is not consistently effective, with little understanding of its influence on the broader plumbing microbiome. Here, we employed a lab-scale recirculating hot water plumbing rig to compare the pre- and post-“heat shock” (i.e., 40 → 60 → 40 °C) microbiota at distal taps. In addition, we used a second plumbing rig to represent a well-managed system at 60 °C and conducted a “control” sampling at 60 °C, subsequently reducing the temperature to 40 °C to observe the effects on Legionella and the microbiota under a simulated “thermal disruption” scenario.ResultsAccording to 16S rRNA gene amplicon sequencing, in the heat shock scenario, there was no significant difference or statistically significant, but small, difference in the microbial community composition at the distal taps pre- versus post-heat shock (both biofilm and water; weighted and unweighted UniFrac distance matrices). While heat shock did lead to decreased total bacteria numbers at distal taps, it did not measurably alter the richness or evenness of the microbiota. Quantitative PCR measurements demonstrated that L. pneumophila relative abundance at distal taps also was not significantly different at 2-month post-heat shock relative to the pre-heat shock condition, while relative abundance of Vermamoeba vermiformis, a known Legionella host, did increase. In the thermal disruption scenario, relative abundance of planktonic L. pneumophila (quantitative PCR data) increased to levels comparable to those observed in the heat shock scenario within 2 months of switching long-term operation at 60 to 40 °C. Overall, water use frequency and water heater temperature set point exhibited a stronger effect than one-time heat shock on the microbial composition and Legionella levels at distal taps.ConclusionsWhile heat shock may be effective for instantaneous Legionella control and reduction in total bacteria numbers, water heater temperature set point and water use frequency are more promising factors for long-term Legionella and microbial community control, illustrating the importance of maintaining consistent elevated temperatures in the system relative to short-term heat shock.
Highlights
Heat shock is a potential control strategy for Legionella pneumophila in hot water plumbing systems
Hot water systems are especially vulnerable to the growth of opportunistic pathogens (OPs), such as Legionella pneumophila and Mycobacteria avium
Implementation of energy and water conservation features can unintentionally increase the risk of OP exposure [10], as was observed in a 400-bed university hospital in Sherbrooke, Canada, where elevated L. pneumophila growth in the hot water system was associated with the installation of a heat exchanger [11]
Summary
Heat shock is a potential control strategy for Legionella pneumophila in hot water plumbing systems. It is not consistently effective, with little understanding of its influence on the broader plumbing microbiome. Elevated temperatures accelerate disinfectant decay (e.g., chlorine, [7]) and predispose hot water systems to deteriorating microbial water quality. Hot water systems are especially vulnerable to the growth of opportunistic pathogens (OPs), such as Legionella pneumophila and Mycobacteria avium. This emphasizes the critical role of design and operation for protecting public health, when serving immunocompromised populations, such as in hospital settings. Inhalation of such aerosols is the primary route of infection, rather than ingestion, as is the emphasis of drinking water regulations [12]
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