title: Coexistence of free-living amoebae and bacteria in selected South African hospital water distribution systems.
abstract: Pathogenic free-living amoebae (FLA), such as Naegleria fowleri, Balamuthia mandrillaris and Acanthamoeba species isolated from aquatic environments have been implicated in central nervous system, eye and skin human infections. They also allow the survival, growth and transmission of bacteria such as Legionella, Mycobacteria and Vibrio species in water systems. The purpose of this study was to investigate the co-occurrence of potentially pathogenic FLA and their associated bacteria in hospital water networks in Johannesburg, South Africa. A total of 178 water (n = 95) and swab (n = 83) samples were collected from two hospital water distribution systems. FLA were isolated using the amoebal enrichment technique and identified using PCR and 18S rDNA sequencing. Amoebae potentially containing intra-amoebal bacteria were lysed and cultured on blood agar plates. Bacterial isolates were characterized using the VITEK®2 compact System. Free-living amoebae were isolated from 77 (43.3 %) of the samples. Using microscopy, PCR and 18S rRNA sequencing, Acanthamoeba spp. (T3 and T20 genotypes), Vermamoeba vermiformis and Naegleria gruberi specie were identified. The Acanthamoeba T3 and T20 genotypes have been implicated in eye and central nervous system infections. The most commonly detected bacterial species were Serratia marcescens, Stenotrophomonas maltophilia, Delftia acidovorans, Sphingomonas paucimobilis and Comamonas testosteroni. These nosocomial pathogenic bacteria are associated with systematic blood, respiratory tract, the urinary tract, surgical wounds and soft tissues infections. The detection of FLA and their associated opportunistic bacteria in the hospital water systems point out to a potential health risk to immune-compromised individuals.
authors.affiliation: Water and Health Research Centre, Faculty of Health Sciences, University of Johannesburg, PO Box 17011, Doornfontein, 2028, South Africa. chesap@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Muchesa
authors.affiliation: Department of Hygiene, Social and Environmental Medicine, Ruhr-University Bochum, Universitätsstraße 150, 44801, Bochum, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Leifels
authors.affiliation: Department of Hygiene, Social and Environmental Medicine, Ruhr-University Bochum, Universitätsstraße 150, 44801, Bochum, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Jurzik
authors.affiliation: Water and Health Research Centre, Faculty of Health Sciences, University of Johannesburg, PO Box 17011, Doornfontein, 2028, South Africa.
authors.forename: K B
authors.initials: KB
authors.lastname: Hoorzook
authors.affiliation: Water and Health Research Centre, Faculty of Health Sciences, University of Johannesburg, PO Box 17011, Doornfontein, 2028, South Africa.
authors.forename: T G
authors.initials: TG
authors.lastname: Barnard
authors.affiliation: Water and Health Research Centre, Faculty of Health Sciences, University of Johannesburg, PO Box 17011, Doornfontein, 2028, South Africa.
authors.forename: C
authors.initials: C
authors.lastname: Bartie
mesh_terms: D000656:Amoeba / Q000145:classification / Q000235:genetics / Q000254:growth & development / Q000302:isolation & purification*; D001419:Bacteria / Q000145:classification / Q000235:genetics / Q000254:growth & development / Q000302:isolation & purification*; D003428:Cross Infection / Q000382:microbiology; D005618:Fresh Water / Q000382:microbiology* / Q000469:parasitology*; D006761:Hospitals; D006801:Humans; D013019:South Africa
keywords: Acanthamoeba spp.; Amoebal enrichment; Serretia marcescens; Vermamoeba vermiformis