Increased Frequency of Nontuberculous Mycobacteria Detection at Potable Water Taps within the United States

Abstract

Nontuberculous mycobacteria (NTMs) are environmental microorganisms that can cause infections in humans, primarily in the lung and soft tissue. The prevalence of NTM-associated diseases is increasing in the United States. Exposure to NTMs occurs primarily through human interactions with water (especially aerosolized). Potable water from sites across the U.S. was collected to investigate the presence of NTM. Water from 68 taps was sampled 4 times over the course of 2 years. In total, 272 water samples were examined for NTM using a membrane filtration, culture method. Identification of NTM isolates was accomplished by polymerase chain reaction (PCR) amplification of the 16S rRNA and hsp65 genes. NTMs were detected in 78% of the water samples. The NTM species detected most frequently were: Mycobacterium mucogenicum (52%), Mycobacterium avium (30%), and Mycobacterium gordonae (25%). Of the taps that were repeatedly positive for NTMs, the species M. avium, M. mucogenicum, and Mycobacterium abscessus were found to persist most frequently. This study also observed statistically significant higher levels of NTM in chloraminated water than in chlorinated water.

The sporadic nature of Legionella pneumophila, Legionella pneumophila Sg1 and Mycobacterium avium occurrence within residences and office buildings across 36 states in the United States

“…Recent outbreak events have been reported in Flint, MI (Legionella) (June, 2014-November, 2015) (MDHHS, 2015), the Bronx, NY (Legionella) (Raphael et al 2016) and Munich, Germany (MAC) (Haller et al 2016). The results from this study and others have shown that the causative microorganisms can be present in water at large and small, newer and older residences (Stout et al 1992;Feazel et al 2009;Donohue et al 2014;Schwake et al 2016) and office buildings (Dutka et al 1984;Flannery et al 2006;Hilborn et al 2006;Moore et al 2006;Donohue et al 2015).…”

Mycobacterium abscessus Complex Infections: A Retrospective Cohort Study

“…Most communities use either chlorine or chloramines and switch back and forth between these products at different times of the year or for operational reasons [29]; there is evidence that bacterial communities shift during water disinfection, and mycobacteria have been found to increase during monochloramine treatment [30]. Furthermore, Donohue et al showed that there are statistically significant higher levels of NTM in nonchlorinated than in chlorinated tap water [31]. Unlike the M. abscessus complex outbreak linked to hospital tap water at a tertiary care hospital in Durham, North Carolina [32], the characteristics of the identified cases included in our study failed to fulfill the criteria for an outbreak as the number of reported cases yearly has remained almost the same throughout the 4 years of our study at all the sites of infection; our cases were not clustered in a particular area or hospital unit, nor were they related to a specific procedure or patient population.…”

A comparative analysis of drinking water employing metagenomics

“…Hypersensitivity pneumonitis has been traced to the presence of NTM in shower heads [69]. In the USA, higher concentrations of NTM have been reported in DWDS disinfected with monochloramine than in DWDS disinfected by chlorination [70]. Haig and colleagues used a high-throughput approach to determine that greater water age, i.e., combined DWDS residence time and home plumbing stagnation time, is associated with a greater relative abundance of M. avium, and DW from locations closer to WTPs contain more diverse NTM spp.…”