Pseudomonas aeruginosa in a hydropathic facility: diversity, susceptibility and imipenem resistance mutation

Abstract

Aims: To detect Pseudomonas aeruginosa in water and treatment equipment biofilms of a thermae hydropathic facility and to study antibiotic susceptibility and genetic diversity. Methods and Results: One hundred and fifty‐four planktonic isolates were obtained from 2220 water samples during 4 years. Seventy‐two biofilm isolates were obtained from 23 samples of inner parts of three inhalation equipments. Antibiotic susceptibility was determined by disc diffusion. All isolates were susceptible to tested antimicrobials, except two biofilm isolates and one planktonic isolate. Twenty‐one resistant mutants were observed (nine from biofilms), mostly with imipenem (IP) resistance (81%), by diminished expression of OprD porin, as it was observed by sodium dodecyl sulfate–polyacrylamide gel electrophoresis (SDS–PAGE). Random amplification polymorphic DNA showed a genetically heterogeneous population that is spread through the entire system and persistent in time. IP resistance mutation ability was spread through the population. Conclusions: The permanent assessment of Ps. aeruginosa is necessary not only in water, as expressed in official programmes, but also in equipments where biofilms are evident. Ps. aeruginosa was more prevalent in biofilm populations and presented higher ability to adapt to antibiotic pressure. Significance and Impact of the Study: Twenty‐one million people use thermae in Europe. Official microbiological quality control programmes only consider water surveillance. Present study proves the need of a review on current official programmes.

Virulence factors and infection ability of Pseudomonas aeruginosa isolates from a hydropathic facility and respiratory infections

“…More than 21 million European patients use this natural therapy (Pereira et al . ), and literature indicates that the majority of thermae users present risk factors to pneumonia (Vinogradova et al . ; Portuguese Spas Association ).…”

“…This natural practice is very frequent in Europe, with more than 21 million users (Pereira et al . ). Treatments are performed using equipments similar to the hospital ventilators, and thermae users deep inhale aerosol particles of undisinfected NMW for about 15–20 min on a daily basis, typically during 7–14 consecutive days.…”

“…Hydrotherapy is a natural therapeutic practice that uses natural mineral water (NMW) to treat several health conditions, including respiratory-associated illnesses such as asthma, bronchitis, emphysema and bronchiectasis, in facilities commonly named thermae. This natural practice is very frequent in Europe, with more than 21 million users (Pereira et al 2011). Treatments are performed using equipments similar to the hospital ventilators, and thermae users deep inhale aerosol particles of undisinfected NMW for about 15-20 min on a daily basis, typically during 7-14 consecutive days.…”

“…A previous study demonstrated the presence of Ps. aeruginosa biofilm isolates in thermae respiratory treatment equipments, with an increased potential to acquire antimicrobial resistance (Pereira et al 2011).…”

Modulation of the gut microbiota by prebiotic fibres and bacteriocins

“…A probiotic strain, Lactobacillus plantarum P-8, caused a shift in the faecal bacterial profile in humans, and this shift has been suggested to be due to the putative plantaricin production by this strain [92]. In another study, nisin F has been suggested to have a stabilizing effect on the bacterial populations in the gut of mice [93]. These studies illustrate the impacts of bacteriocins on the gut microbiota; however, they vary greatly in terms of the administration method, the model used in the experimental design and the use of proper negative controls.…”