Free-living amoebae isolated from a hospital water system in South Africa: A potential source of nosocomial and occupational infection

Abstract: This study investigated the occurrence of free-living amoebae (FLA) in a public hospital in South Africa. A total of 97 water and biofilm samples from the municipal water inlet of the hospital, theatres, theatre sterilization service unit, central sterilization service unit, endoscopy/gastroscopy unit, intensive care unit and the renal unit were collected and examined for the presence of FLA using an amoebal co-culture and molecular techniques. Of the 97 samples, 77 (79.4 %), 40 (52%) water and 37 (48.1%) biofilm, contained FLA. The genera Acanthamoeba, Vermamoeba (formerly Hartmanella) and Naegleria were detected by morphology, 18S rRNA PCR and sequence analyses. Further sequence analysis of the five Acanthamoeba positive isolates revealed a close resemblance with the potentially pathogenic T20 genotype. These results show a potential health risk to immuno-compromised patients and health care workers as some of the species detected are pathogenic and may harbour potential intracellular bacteria responsible for nosocomial infections. To date, this is the first report on the detection of potentially pathogenic amoebae from South African hospital water systems

Detection of amoeba-associated Legionella pneumophila in hospital water networks of Johannesburg

Abstract: The prevalence of free-living amoeba and associated Legionella spp. in hospital water systems may pose a risk of Legionnaires’ disease to immuno-compromised patients. This study investigated the occurrence of amoeba-associated Legionella pneumophila in three South African hospital water systems. A total of 98 water and/or biofilm samples were collected from the sterilisation unit, theatres, neonatal ward and intensive care units. Amoebae were isolated from 71 (72.4%) samples. Isolated amoebae were analysed using qPCR and culture methods to test for the presence of Legionella. L. pneumophila did not grow on selective media in any of the samples. A total of 7 out of the 71 (9.9%) amoeba-positive samples showed a positive reaction for L. pneumophila using qPCR. Although relatively few samples were positive for Legionella in this preliminary study, the association with amoeba still presents a potential public health risk to immuno-compromised patients when exposed to contaminated water

Microbial and viral pathogens in freshwater: Current research aspects studied in Germany.

Continuous research in the field of water and health is important to ensure high standards of hygiene and to improve microbial risk assessment and water management. Various waterborne outbreaks induced by pathogenic bacteria, viruses and protozoa have been reported in recent decades. Pathogens derived from human and animal feces have been played frequently a key role in contaminations of freshwater. Reasons for the presence of pathogens in drinking water systems are insufficient wastewater treatment, contaminated raw water or damaged water supply systems. Numerous routes of transmission and the distribution of individual pathogens by raw water and drinking water constitute potential hazards to public health. Recently, different research activities have been initiated in Germany, which focus on the examination of pathogens in water to establish a modern microbial risk assessment according to the high-tech strategy employed by the federal government. This review article provides a compilation of the pathogens that are important in German water bodies (wastewater, surface water, groundwater, and drinking water) and includes coverage of German research on pathogens and technologies for reducing these pathogens in water, challenges to research, and recent developments in concentration and detection methods for pathogens. Finally, current knowledge gaps and ongoing research questions are highlighted

Awake craniotomy for resection of a cerebral AVM within Broca's area

Fecal contamination of water resources is a major public health concern in densely populated areas since these water bodies are used for drinking water production or recreational purposes. A main source of this contamination originates from combined sewer overflows (CSOs) in regions with combined sewer systems. Thus, the treatment of CSO discharges is urgent. In this study, we explored whether ozonation or UV irradiation can efficiently reduce pathogenic bacteria, viruses, and protozoan parasites in CSOs. Experiments were carried out in parallel settings at the outflow of a stormwater settling tank in the Ruhr area, Germany. The results showed that both techniques reduce most hygienically relevant bacteria, parasites and viruses. Under the conditions tested, ozonation yielded lower outflow values for the majority of the tested parameters. © 2015 Elsevier GmbH

Dysbalance in sympathetic neurotransmitter release and action in cirrhotic rats: impact of exogenous neuropeptide Y

BACKGROUND & AIMS: Splanchnic vasodilation is an essential disturbance in portal hypertension. Increased systemic sympathetic nerve activity is well known, but potential corresponding vascular desensitization is incompletely characterized. Release of splanchnic sympathetic neurotransmitters noradrenaline (NA) and co-transmitter neuropeptide Y (NPY) remains to be elucidated. Finally, the effects of exogenous NPY on these mechanisms are unexplored. METHODS: Portal vein ligated cirrhotic, and control rats were used for in vitro perfusion of mesenteric arteries. Depletion of vascular pressure response was induced by repetitive electric sympathetic perivascular nerve stimulation (PNS) and performed in the absence and presence of exogenous NPY. Additionally, PNS-induced release of NA and NPY was measured. RESULTS: Mesenteric PNS-induced pressure response was lower in portal hypertension. Depletion of the pressure response to PNS, representing the degree of desensitization, was enhanced in portal hypertension. NA release was elevated, whereas NPY release was attenuated in cirrhosis. Administration of exogenous NPY led to marked recovery from desensitization and vasoconstrictive improvement in cirrhotic rats, being associated with more pronounced decrease of NA release. CONCLUSIONS: Pronounced depletion of splanchnic arterial pressure-response to repetitive sympathetic nerve stimulation in cirrhosis is partly attributable to altered NA release as well as to deficient NPY release. External NPY restores vascular contractility and attenuates pathologically elevated NA release in the portal hypertensive mesenteric vasculature, revealing post-, and prejunctional effects at the vascular smooth muscle motor endplate; therefore outlining encouraging therapeutic strategies