title: Removal of Mycobacterium avium subspecies hominissuis (MAH) from drinking water by coagulation, flocculation and sedimentation processes.
abstract: There has been a growing concern over human exposure to Mycobacterium avium subspecies hominissuis (MAH) through drinking water due to its ubiquitous presence in natural waters and remarkable resistance to both chemical and physical disinfectants in drinking water treatment processes. However, little is known about the effectiveness of physico-chemical water treatment processes to remove MAH. Therefore, we determined the removal of MAH by alum coagulation, flocculation and sedimentation processes in optimized drinking water treatment conditions using standard jar test equipment. Contrary to the prevailing hypothesis, the results of this study show that removal of MAH by coagulation, flocculation and sedimentation processes was only moderate (approx. 0.65 log10) under low turbidity treatment conditions and the removal of MAH was actually lower than that of Escherichia coli (reference bacterium) in all the waters tested. Overall, the results of this study suggested that coagulation, flocculation and sedimentation processes may not be a reliable treatment option for removing MAH, and more efforts to find an effective control measures against MAH should be made to reduce the risk of MAH infection from drinking water.
  
  
  CONCLUSIONS
  Despite a growing concern over human exposure to Mycobacterium avium subspecies hominissuis (MAH) through drinking water and its remarkable resistance to water disinfectants, little is known about the effectiveness of physico-chemical water treatment processes to remove MAH. Contrary to the prevailing hypothesis, the results of this study suggest that coagulation, flocculation and sedimentation processes may not be a reliable treatment option for MAH removal. As these processes have been the last remaining conventional drinking water treatment processes that might be effective against MAH, more efforts should be urgently made to find an effective control measures against this important waterborne pathogen.
authors.affiliation: Molecular Genetics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: E A
authors.initials: EA
authors.lastname: Wong
authors.forename: G-A
authors.initials: GA
authors.lastname: Shin
mesh_terms: D000534:Alum Compounds / Q000737:chemistry; D060766:Drinking Water / Q000382:microbiology*; D005427:Flocculation; D006801:Humans; D009162:Mycobacterium avium / Q000302:isolation & purification*; D015269:Mycobacterium avium Complex / Q000302:isolation & purification*; D014871:Water Microbiology; D014876:Water Pollution; D018508:Water Purification / Q000379:methods*
chemical_list: D000534:Alum Compounds; D060766:Drinking Water; C041524:aluminum sulfate
keywords: Mycobacterium avium complex; Mycobacterium avium subspecies hominissuis; coagulation; drinking water; jar test