title: Dose-response algorithms for water-borne Pseudomonas aeruginosa folliculitis.
abstract: We developed two dose-response algorithms for P. aeruginosa pool folliculitis using bacterial and lesion density estimates, associated with undetectable, significant, and almost certain folliculitis. Literature data were fitted to Furumoto & Mickey's equations, developed for plant epidermis-invading pathogens: N l = A ln(1 + BC) (log-linear model); P inf = 1-e(-r c C) (exponential model), where A and B are 2.51644 × 107 lesions/m2 and 2.28011 × 10-11 c.f.u./ml P. aeruginosa, respectively; C = pathogen density (c.f.u./ml), N l = folliculitis lesions/m2, P inf = probability of infection, and r C = 4·3 × 10-7 c.f.u./ml P. aeruginosa. Outbreak data indicates these algorithms apply to exposure durations of 41 ± 25 min. Typical water quality benchmarks (≈10-2 c.f.u./ml) appear conservative but still useful as the literature indicated repeated detection likely implies unstable control barriers and bacterial bloom potential. In future, culture-based outbreak testing should be supplemented with quantitative polymerase chain reaction and organic carbon assays, and quantification of folliculitis aetiology to better understand P. aeruginosa risks.
authors.affiliation: UNSW Water Research Centre, School of Civil and Environmental Engineering, University of New South Wales,Sydney,New South Wales,Australia.
authors.forename: D J
authors.initials: DJ
authors.lastname: Roser
authors.affiliation: UNSW Water Research Centre, School of Civil and Environmental Engineering, University of New South Wales,Sydney,New South Wales,Australia.
authors.forename: B
authors.initials: B
authors.lastname: Van Den Akker
authors.affiliation: Department of Otorhinolaryngology,Head and Neck Surgery,The Queen Elizabeth Hospital,Woodville,SA,Australia.
authors.forename: S
authors.initials: S
authors.lastname: Boase
authors.affiliation: Department of Civil,Architectural and Environmental Engineering,Drexel University,Philadelphia,USA.
authors.forename: C N
authors.initials: CN
authors.lastname: Haas
authors.affiliation: UNSW Water Research Centre, School of Civil and Environmental Engineering, University of New South Wales,Sydney,New South Wales,Australia.
authors.forename: N J
authors.initials: NJ
authors.lastname: Ashbolt
authors.affiliation: The School of Biotechnology and Biomolecular Sciences and the Centre for Marine Bio-Innovation, University of New South Wales,Sydney,New South Wales,Australia.
authors.forename: S A
authors.initials: SA
authors.lastname: Rice
mesh_terms: D000465:Algorithms; D005499:Folliculitis / Q000382:microbiology*; D006801:Humans; D011552:Pseudomonas Infections / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000502:physiology*; D013551:Swimming Pools; D013997:Time Factors; D014871:Water Microbiology
keywords: folliculitis