title: Methodological approaches for monitoring opportunistic pathogens in premise plumbing: A review.
abstract: Opportunistic premise (i.e., building) plumbing pathogens (OPPPs, e.g., Legionella pneumophila, Mycobacterium avium complex, Pseudomonas aeruginosa, Acanthamoeba, and Naegleria fowleri) are a significant and growing source of disease. Because OPPPs establish and grow as part of the native drinking water microbiota, they do not correspond to fecal indicators, presenting a major challenge to standard drinking water monitoring practices. Further, different OPPPs present distinct requirements for sampling, preservation, and analysis, creating an impediment to their parallel detection. The aim of this critical review is to evaluate the state of the science of monitoring OPPPs and identify a path forward for their parallel detection and quantification in a manner commensurate with the need for reliable data that is informative to risk assessment and mitigation. Water and biofilm sampling procedures, as well as factors influencing sample representativeness and detection sensitivity, are critically evaluated with respect to the five representative bacterial and amoebal OPPPs noted above. Available culturing and molecular approaches are discussed in terms of their advantages, limitations, and applicability. Knowledge gaps and research needs towards standardized approaches are identified.
authors.affiliation: State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai 200092, China. Electronic address: hongwang@tongji.edu.cn.
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Civil Engineering, Polytechnique Montreal, Montreal, QC, Canada.
authors.forename: Emilie
authors.initials: E
authors.lastname: Bédard
authors.affiliation: Department of Civil Engineering, Polytechnique Montreal, Montreal, QC, Canada.
authors.forename: Michèle
authors.initials: M
authors.lastname: Prévost
authors.affiliation: Center for Biofilm Engineering and Department of Civil Engineering, Montana State University, Bozeman, MT 59717, USA.
authors.forename: Anne K
authors.initials: AK
authors.lastname: Camper
authors.affiliation: Waterborne Disease Prevention Branch, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329, USA.
authors.forename: Vincent R
authors.initials: VR
authors.lastname: Hill
authors.affiliation: Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA 24061, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Pruden
mesh_terms: D000656:Amoeba; D060766:Drinking Water / Q000382:microbiology*; D006801:Humans; D016952:Legionella pneumophila; D011550:Pseudomonas aeruginosa; D012498:Sanitary Engineering; D014871:Water Microbiology; D014881:Water Supply
chemical_list: D060766:Drinking Water
keywords: Culturing; Molecular methods; Opportunistic pathogens; Premise plumbing; Sampling procedures