Abstract
The purpose of this study was to investigate the occurrence of free-living amoebae in the water system of a teaching hospital in Johannesburg (South Africa). Water and biofilm samples were collected from the theatres, theatre sterilisation service unit, central sterilisation service unit and endoscopy/bronchoscopy unit. The samples were filtered and seeded on non-nutrient agar spread with heat-killed Escherichia coli. Of the 71 samples collected, 63 (88.7%) were positive for free-living amoeba. Acanthamoeba spp., Balamuthia spp. and Hartmanella spp. were identified by morphology. The presence of free-living amoeba in the hospital water network may be a potential health risk.
Highlights
Free-living amoebae (FLA) are useful as predators of bacteria, algae, viruses and fungi in the environment, some species – Naegleria fowleri, Balamuthia mandrillaris, Sappinia pedata and Acanthamoeba species – have been implicated in infections of the central nervous system, eye and skin.[3,4]
Typical Acanthamoeba spp., Balamuthia spp. and Hartmanella spp. were observed in samples that were positive based on their morphology (Figure 1)
Negative samples were from the theatre sterilisation service unit (2), the central sterilisation service unit (2), the endoscopy/bronchoscopy unit (2) and theatres (3)
Summary
Free-living amoebae (FLA) are unicellular protozoans that are widely distributed in aquatic environments, including constructed water systems such as hospital water systems and swimming pools.[1,2] FLA are useful as predators of bacteria, algae, viruses and fungi in the environment, some species – Naegleria fowleri, Balamuthia mandrillaris, Sappinia pedata and Acanthamoeba species – have been implicated in infections of the central nervous system, eye and skin.[3,4] Some FLA allow the survival and growth of bacterial pathogens linked to nosocomial infections such as Legionella pneumophila, Mycobacteria, Pseudomonas aerugionosa and Acinetobacter baumannii. Intracellular bacteria within FLA cysts are protected from hostile environmental conditions such as the presence of biocides used in water treatment.[5,6] FLA may serve as vehicles for transmission of waterborne bacterial pathogens, enabling them to spread and colonise hospital water systems. The presence of FLA in hospital water supplies may present a potential health concern for medical personnel and immunocompromised patients
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