Swimming pool bacteria

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Swimming pool bacteria are the diverse array of bacteria that are present in aquatic environments, primarily swimming pools, which can have effects on human health and water quality. Recreational waters are known to be source of infectious diseases. [1]

Contents

Types

There are different types of bacteria that are found in swimming pools and other types of recreational waters. The most prevalent of them is Staphylococcus aureus (S. aureus). This bacterium is one of the leading causes of skin infections in the world. Such infections could appear as painful boils and rashes. [2] It is naturally present in humans on skin, in nasal mucous, and inside the intestinal tract. [3] S. aureus has a strong resistance to chlorine, which is one of the methods by which pools are often cleaned. [4]

Other bacteria often found in recreational waters are Enterococci, [5] which is a genus of bacteria found in feces. Fecal contamination is one of the primary public health concerns in swimming pools. [4] Fecal contamination usually occurs through excretion by bathers, other animals, or contaminated water sources. [4]

Levels found in recreational waters

Researchers have studied the quantity of bacteria in recreational waters. In a study of swimming pools in Alexandria, Egypt, [4] the team studied 10 pools, both indoor and outdoor, over two months during the summer. [4] The team found that bacteria seemed to be more prevalent in outdoor pools. [4] Furthermore, they noted that the higher the pH of the pool, the more bacteria were present in the water. 20.2% of the bacteria in the pools were found to be S. aureus . [4]

Another study reported two experiments involving a large pool and a small pool. [5] Using 10 volunteers, the team examined how many bacteria could be found in the watershed by the bathers and how many could be found in the water after the bathers were exposed to sand. [5] The study concluded that bathers shed both S. aureus and enterococci into the water, and S. aureus was shed the most. [5] After each cycle, the number of bacteria the bathers shed decreased. [5]

Enterotoxic Escherichia coli has been found in pools with sub-optimal chlorine levels. [1]

Disease prevention

There are several diseases caused by S. aureus and enterococci . S. aureus has been found to cause sepsis and pneumonia, among other problems, [6] while Enterococci has been found to cause sepsis and urinary tract infections, [7] as well as being resistant to antibiotics. [8] There are various actions taken to prevent swimmers from falling ill. The swimming facilities must ensure that their filtration is working and that their staff are trained and know the appropriate behavior and procedures of the facilities. [9] Individual swimmers must also take preventative measures. As stated by the Centers for Disease Control and Prevention (CDC), guests must not swim if they have diarrhea, swimmers should not swallow pool water, swimmers should wash themselves before entering the pool, and if the restroom is used, each guest must thoroughly wash themselves. [9]

In Europe, the cleanliness of pools is monitored by measuring the levels Escherichia coli, enterococci and Pseudomonas aeruginosa. Staphylococcus aureus levels are not monitored despite the detection of the bacteria in recreational waters (and on beaches). [10] The authors of a 2023 study recommended levels of bacteria of 0 CFU/100 mL for water of excellent quality, less than 20 CFU/100 mL for water of very good quality, less than 50 CFU/100 mL for good quality water, and more than 50 CFU/100 mL for poor quality water. [10]

Related Research Articles

<i>Staphylococcus aureus</i> Species of Gram-positive bacterium

Staphylococcus aureus is a Gram-positive spherically shaped bacterium, a member of the Bacillota, and is a usual member of the microbiota of the body, frequently found in the upper respiratory tract and on the skin. It is often positive for catalase and nitrate reduction and is a facultative anaerobe that can grow without the need for oxygen. Although S. aureus usually acts as a commensal of the human microbiota, it can also become an opportunistic pathogen, being a common cause of skin infections including abscesses, respiratory infections such as sinusitis, and food poisoning. Pathogenic strains often promote infections by producing virulence factors such as potent protein toxins, and the expression of a cell-surface protein that binds and inactivates antibodies. S. aureus is one of the leading pathogens for deaths associated with antimicrobial resistance and the emergence of antibiotic-resistant strains, such as methicillin-resistant S. aureus (MRSA), is a worldwide problem in clinical medicine. Despite much research and development, no vaccine for S. aureus has been approved.

<i>Enterococcus</i> Genus of bacteria

Enterococcus is a large genus of lactic acid bacteria of the phylum Bacillota. Enterococci are gram-positive cocci that often occur in pairs (diplococci) or short chains, and are difficult to distinguish from streptococci on physical characteristics alone. Two species are common commensal organisms in the intestines of humans: E. faecalis (90–95%) and E. faecium (5–10%). Rare clusters of infections occur with other species, including E. casseliflavus, E. gallinarum, and E. raffinosus.

Methicillin-resistant <i>Staphylococcus aureus</i> Bacterium responsible for difficult-to-treat infections in humans

Methicillin-resistant Staphylococcus aureus (MRSA) is a group of gram-positive bacteria that are genetically distinct from other strains of Staphylococcus aureus. MRSA is responsible for several difficult-to-treat infections in humans. It caused more than 100,000 deaths worldwide attributable to antimicrobial resistance in 2019.

Bloodstream infections (BSIs) are infections of blood caused by blood-borne pathogens. The detection of microbes in the blood is always abnormal. A bloodstream infection is different from sepsis, which is characterized by severe inflammatory or immune responses of the host organism to pathogens.

<span class="mw-page-title-main">Hospital-acquired infection</span> Infection that is acquired in a hospital or other health care facility

A hospital-acquired infection, also known as a nosocomial infection, is an infection that is acquired in a hospital or other healthcare facility. To emphasize both hospital and nonhospital settings, it is sometimes instead called a healthcare-associated infection. Such an infection can be acquired in a hospital, nursing home, rehabilitation facility, outpatient clinic, diagnostic laboratory or other clinical settings. A number of dynamic processes can bring contamination into operating rooms and other areas within nosocomial settings. Infection is spread to the susceptible patient in the clinical setting by various means. Healthcare staff also spread infection, in addition to contaminated equipment, bed linens, or air droplets. The infection can originate from the outside environment, another infected patient, staff that may be infected, or in some cases, the source of the infection cannot be determined. In some cases the microorganism originates from the patient's own skin microbiota, becoming opportunistic after surgery or other procedures that compromise the protective skin barrier. Though the patient may have contracted the infection from their own skin, the infection is still considered nosocomial since it develops in the health care setting. Nosocomial infection tends to lack evidence that it was present when the patient entered the healthcare setting, thus meaning it was acquired post-admission.

<span class="mw-page-title-main">Staphylococcal enteritis</span> Medical condition

Staphylococcal enteritis is an inflammation that is usually caused by eating or drinking substances contaminated with staph enterotoxin. The toxin, not the bacterium, settles in the small intestine and causes inflammation and swelling. This in turn can cause abdominal pain, cramping, dehydration, diarrhea and fever.

Vancomycin-resistant <i>Staphylococcus aureus</i> Antibiotica resistant bacteria

Vancomycin-resistant Staphylococcus aureus (VRSA) are strains of Staphylococcus aureus that have acquired resistance to the glycopeptide antibiotic vancomycin. Bacteria can acquire resistant genes either by random mutation or through the transfer of DNA from one bacterium to another. Resistance genes interfere with the normal antibiotic function and allow a bacteria to grow in the presence of the antibiotic. Resistance in VRSA is conferred by the plasmid-mediated vanA gene and operon. Although VRSA infections are uncommon, VRSA is often resistant to other types of antibiotics and a potential threat to public health because treatment options are limited. VRSA is resistant to many of the standard drugs used to treat S. aureus infections. Furthermore, resistance can be transferred from one bacterium to another.

Vancomycin-resistant <i>Enterococcus</i> Bacterial strains of Enterococcus that are resistant to the antibiotic vancomycin

Vancomycin-resistant Enterococcus, or vancomycin-resistant enterococci (VRE), are bacterial strains of the genus Enterococcus that are resistant to the antibiotic vancomycin.

<i>Enterococcus faecalis</i> Species of bacterium

Enterococcus faecalis – formerly classified as part of the group D Streptococcus system – is a Gram-positive, commensal bacterium inhabiting the gastrointestinal tracts of humans. Like other species in the genus Enterococcus, E. faecalis is found in healthy humans and can be used as a probiotic. The probiotic strains such as Symbioflor1 and EF-2001 are characterized by the lack of specific genes related to drug resistance and pathogenesis. As an opportunistic pathogen, E. faecalis can cause life-threatening infections, especially in the nosocomial (hospital) environment, where the naturally high levels of antibiotic resistance found in E. faecalis contribute to its pathogenicity. E. faecalis has been frequently found in reinfected, root canal-treated teeth in prevalence values ranging from 30% to 90% of the cases. Re-infected root canal-treated teeth are about nine times more likely to harbor E. faecalis than cases of primary infections.

Indicator bacteria are types of bacteria used to detect and estimate the level of fecal contamination of water. They are not dangerous to human health but are used to indicate the presence of a health risk.

<span class="mw-page-title-main">Swimming pool sanitation</span> Overview about the swimming pool sanitation

Swimming pool sanitation is the process of ensuring healthy conditions in swimming pools. Proper sanitation is needed to maintain the visual clarity of water and to prevent the transmission of infectious waterborne diseases.

Enterococcus faecium is a Gram-positive, gamma-hemolytic or non-hemolytic bacterium in the genus Enterococcus. It can be commensal in the gastrointestinal tract of humans and animals, but it may also be pathogenic, causing diseases such as neonatal meningitis or endocarditis.

<span class="mw-page-title-main">Cefoxitin</span> Chemical compound

Cefoxitin is a second-generation cephamycin antibiotic developed by Merck & Co., Inc. from Cephamycin C in the year following its discovery, 1972. It was synthesized in order to create an antibiotic with a broader spectrum. It is often grouped with the second-generation cephalosporins. Cefoxitin requires a prescription and as of 2010 is sold under the brand name Mefoxin by Bioniche Pharma, LLC. The generic version of cefoxitin is known as cefoxitin sodium.

Indicator organisms are used as a proxy to monitor conditions in a particular environment, ecosystem, area, habitat, or consumer product. Certain bacteria, fungi and helminth eggs are being used for various purposes.

<span class="mw-page-title-main">Staphylococcal infection</span> Medical condition

A staphylococcal infection or staph infection is an infection caused by members of the Staphylococcus genus of bacteria.

<i>Staphylococcus</i> Genus of Gram-positive bacteria

Staphylococcus is a genus of Gram-positive bacteria in the family Staphylococcaceae from the order Bacillales. Under the microscope, they appear spherical (cocci), and form in grape-like clusters. Staphylococcus species are facultative anaerobic organisms.

<span class="mw-page-title-main">Sophoraflavanone G</span> Chemical compound

Sophoraflavanone G is a volatile phytoncide, released into the atmosphere, soil and ground water, by members of the Sophora genus. Sophora pachycarpa, and Sophora exigua; all found to grow within the United States in a variety of soil types, within temperate conditions, no lower than 0 °F. Sophoraflavanone G is released in order to protect the plant against harmful protozoa, bacteria, and fungi. Sophoraflavanone G, also called kushenin, is a flavonoid compound.

<span class="mw-page-title-main">Beach advisory</span> Warning given by a local government to avoid swimming in a body of water

A beach advisory is a warning given by a local government to avoid swimming in a body of water. Beach advisories do not automatically close bodies of water to swimmers but instead function as a warning to swimmers against swimming at a particular site.

<span class="mw-page-title-main">Respiratory risks of indoor swimming pools</span>

Respiratory risks of indoor swimming pools can include coughing, wheezing, aggravated asthma, and airway hyper-responsiveness. The chemicals used for pool water disinfection can react with organic compounds in the water to create disinfection by-products or DBPs. Exposure to these DBPs are the potential cause for respiratory symptoms in swimmers. Multiple studies have shown the potential correlation between chronic exposure to DBPs and respiratory symptoms among competitive swimmers but more research is needed on the effects of these DBPs on recreational swimmers. The studies on recreational swimmers that have been done show a decreased risk for respiratory symptoms due to a decreased exposure to DBPs. Some studies have been done on the vulnerability of younger children and DBP exposure. Studies done on the vulnerability of younger children demonstrate that immature lungs are more likely to absorb more of these DBPs.

ESKAPE is an acronym comprising the scientific names of six highly virulent and antibiotic resistant bacterial pathogens including: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. The acronym is sometimes extended to ESKAPEE to include Escherichia coli. This group of Gram-positive and Gram-negative bacteria can evade or 'escape' commonly used antibiotics due to their increasing multi-drug resistance (MDR). As a result, throughout the world, they are the major cause of life-threatening nosocomial or hospital-acquired infections in immunocompromised and critically ill patients who are most at risk. P. aeruginosa and S. aureus are some of the most ubiquitous pathogens in biofilms found in healthcare. P. aeruginosa is a Gram-negative, rod-shaped bacterium, commonly found in the gut flora, soil, and water that can be spread directly or indirectly to patients in healthcare settings. The pathogen can also be spread in other locations through contamination, including surfaces, equipment, and hands. The opportunistic pathogen can cause hospitalized patients to have infections in the lungs, blood, urinary tract, and in other body regions after surgery. S. aureus is a Gram-positive, cocci-shaped bacterium, residing in the environment and on the skin and nose of many healthy individuals. The bacterium can cause skin and bone infections, pneumonia, and other types of potentially serious infections if it enters the body. S. aureus has also gained resistance to many antibiotic treatments, making healing difficult. Because of natural and unnatural selective pressures and factors, antibiotic resistance in bacteria usually emerges through genetic mutation or acquires antibiotic-resistant genes (ARGs) through horizontal gene transfer - a genetic exchange process by which antibiotic resistance can spread.

References

  1. 1 2 Verma A, Bolton FJ, Fiefield D, Lamb P, Woloschin E, Smith N, et al. (August 2007). "An outbreak of E. coli O157 associated with a swimming pool: an unusual vehicle of transmission". Epidemiology and Infection. 135 (6): 989–92. doi:10.1017/S0950268807007947. PMC   2870659 . PMID   17288639.
  2. ↑ "Infection caused by staphylococcus bacteria-Staph infections - Symptoms & causes". Mayo Clinic. Retrieved 2024-04-27.
  3. ↑ Acton DS, Plat-Sinnige MJ, van Wamel W, de Groot N, van Belkum A (February 2009). "Intestinal carriage of Staphylococcus aureus: how does its frequency compare with that of nasal carriage and what is its clinical impact?". Eur J Clin Microbiol Infect Dis. 28 (2): 115–27. doi:10.1007/s10096-008-0602-7. PMID   18688664.
  4. 1 2 3 4 5 6 7 Masoud G, Abbass A, Abaza A, Hazzah W (July 2016). "Bacteriological quality of some swimming pools in Alexandria with special reference to Staphylococcus aureus". Environmental Monitoring and Assessment. 188 (7): 412. Bibcode:2016EMnAs.188..412M. doi:10.1007/s10661-016-5427-8. PMID   27312255.
  5. 1 2 3 4 5 Elmir SM, Wright ME, Abdelzaher A, Solo-Gabriele HM, Fleming LE, Miller G, et al. (January 2007). "Quantitative evaluation of bacteria released by bathers in a marine water". Water Research. 41 (1): 3–10. Bibcode:2007WatRe..41....3E. doi:10.1016/j.watres.2006.10.005. PMC   2633726 . PMID   17113123.
  6. ↑ "Staphylococcus aureus in Healthcare Settings | HAI | CDC". www.cdc.gov. 2020-12-10. Retrieved 2024-05-13.
  7. ↑ "Enterococcal Infections - Infectious Diseases". Merck Manual Professional Edition. Retrieved 2024-05-13.
  8. ↑ Kristich CJ, Rice LB, Arias CA (2014), Gilmore MS, Clewell DB, Ike Y, Shankar N (eds.), "Enterococcal Infection—Treatment and Antibiotic Resistance", Enterococci: From Commensals to Leading Causes of Drug Resistant Infection, Boston: Massachusetts Eye and Ear Infirmary, PMID   24649502 , retrieved 2024-05-13
  9. 1 2 "Preventing Recreational Water Illnesses at Your Facility | Healthy Swimming | Healthy Water". www.cdc.gov. 2023-04-14. Retrieved 2024-04-27.
  10. 1 2 Mahy JG, Luizi F (June 2023). "Review on the management of water quality for bio-mineral swimming pools in Western Europe". Environ Monit Assess. 195 (7): 872. doi:10.1007/s10661-023-11502-4. PMID   37351694.
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