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Waterborne Pathogens in Healthcare Environments

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We use water everyday for cleaning activities: When we wash our hands, take a shower, mop the floors, etc. But did you know that many microorganisms can live on nutrient-depleted environments including water and use several survival strategies to reside in plumbing systems and live there for several years? They are known as waterborne pathogens and can cause severe illnesses. Vibrio cholera, Salmonella enterica, Escherichia coli and Pseudomonas aeruginosa represent some of the most important bacteria in this group.

It is crucial to have access to safe water but also impossible not to get exposed to contaminated water in our daily lives. Even our drinking water could be contaminated, or our food could be prepared by using contaminated water. The reason why many of the healthy individuals do not get infected by waterborne pathogens is because many of the bacteria in this group are classified as opportunistic pathogens, meaning that they are only able to infect people whose immune systems are suppressed. Knowing that immune-suppressed patients such as cancer patients either stay in the hospital or have frequent hospital visits during their treatment, it is vital to provide them safe water.

There are many water regulations in developed countries to control water quality in healthcare environments. Water testing should be done in frequent intervals for microbiological analysis. If the outlets are found to be contaminated, remedial actions such as chemical or thermal disinfection, replacement of sink/shower units should be done followed by further testing to ensure their effectiveness. Unfortunately, once bacteria reside in water systems, it is very difficult to eradicate them. Materials used in plumbing are also important as many of them such as rubber and EPDM (ethylene propylene diene monomer) are known to promote bacterial growth.

Waterborne pathogens in hospitals such as E. coli and P. aeruginosa are leading causes of hospital-acquired infections (HAIs). Many studies showed direct links between clinical and environmental bacteria emphasising the importance of cleaning practices. Patients, visitors, and hospital personnel are at high risk of getting HAIs. Causative agents of HAIs are usually resistant to many antibiotics as they develop resistance mechanisms through frequent exposure to antimicrobial agents. Therefore, once infected by a hospital pathogen, it is very difficult to find the effective antibiotic to get cured.

All in all, life without water is impossible but we should as well be careful when using it to have a healthy life. Importance of waterborne pathogens should not be underestimated especially in healthcare facilities to protect the patients in high-risk groups.