Abstract
The World Health Organization guidelines prioritize the detection of coliform bacteria as indicators of water contamination. However, non-fermentative gram-negative bacteria, which pose a potential contamination risk, are not included in these guidelines. This study aimed to isolate and identify these bacteria in public hospital water supply systems in Sulaymaniyah city and evaluate their susceptibility to antibiotics. Water samples were collected from four hospitals, and non-fermentative gram-negative colonies were isolated using two media: MacConkey and Chromogenic Coliform agar (CCA). The identification of these colonies was performed using the automated system VITEK 2. The bacterial isolates’ sensitivity to 10 antibiotics was determined using a Kirby-Bauer Disk Diffusion Susceptibility Test.
Five species of non-fermentative gram-negative bacteria were identified, including Moraxella lacunata, Achromobacter denitrificans, Brevundimonas diminuta, Acinetobacter lwoffii, and Pseudomonas fluorescens. Notably, Moraxella lacunata was found in all hospitals and was resistant to six of the antibiotics. The other four species exhibited a distribution pattern across the different hospitals and showed varying degrees of sensitivity to the ten used antibiotics. Significantly, the successful implementation of CCA media, typically utilized for the isolation and identification of E. coli and coliform bacteria, proved advantageous in isolating Non-Fermenting Gram-Negative Bacteria during this study. This study emphasizes the risk of non-fermentative gram-negative bacteria in hospital water systems for vulnerable patients. Current WHO guidelines do not prioritize monitoring these bacteria. Regular monitoring and proper management are crucial to prevent infections from these waterborne pathogens.
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Data sharing is not applicable to this article as no datasets were generated or analysed during the current study.
Abbreviations
- WHO:
-
World Health Organization
- NFGNB:
-
Non-fermentative gram-negative bacteria
- CCA:
-
Chromogenic Coliform agar
- CLSI:
-
Clinical and Laboratory Standards Institute
References
Afsharyavari S (2022) Multidrug resistance among clinical isolates of Acinetobacter lwoffii. J Res Appl Basic Med Sci 8:104–109. https://doi.org/10.52547/rabms.8.2.104
Anaissie EJ, Penzak SR, Dignani MC (2002) The hospital water supply as a source of nosocomial infections. Arch Intern Med 162:1483. https://doi.org/10.1001/archinte.162.13.1483
Blondel-Hill E, Henry DA, Speert DP (2007) Pseudomonas. In: Murray PR, Baron EJ, Jorgensen JH, Landry ML, Pfaller MA (eds) Manual of clinical microbiology, 9th edn. ASM Press, pp 734–748
Breijyeh Z, Jubeh B, Karaman R (2020) Resistance of gram-negative bacteria to current antibacterial agents and approaches to resolve it. Mol 25:1340. https://doi.org/10.3390/molecules25061340
Cankaya E, Keles M, Gulcan E, Uyanik A, Uyanik H (2014) A rare cause of peritoneal dialysis-related peritonitis: Achromobacter denitrificans. Perit Dial Int 34:135–137. https://doi.org/10.3747/pdi.2013.00063
Clinical and Laboratory Standards Institute (2017) Performance standards for antimicrobial susceptibility testing, 27th edn. Clinical and Laboratory Standards Institute, Wayne, Pa
Donofrio RS, Bestervelt LL, Saha R, Bagley ST (2010) Selective enumeration strategies for Brevundimonas diminuta from drinking water. J Ind Microbiol Biotechnol 37:407–417. https://doi.org/10.1007/s10295-010-0689-6
Encyclopedia of Microbiology (2009) Species of Achromobacter, Alcaligenes, Flavobacterium, Acinetobacter, and Pseudomonas are some of the other bacteria that have been associated with infrequent cases of beer spoilage. In: Schaechter M (ed) Encyclopedia of Microbiology, 3rd edn. Academic Press, pp 225–237
Enoch DA, Birkett CI, Ludlam HA (2007) Non-fermentative gram-negative bacteria. Int J Antimicrob Agents 29:S33–S41. https://doi.org/10.1016/s0924-8579(07)72176-3
Forster B, Pinedo CA (2015) Bacteriological examination of waters: membrane filtration protocol. Am Soc Microbiol
Huddam B, Koçak G, Azak A, Duranay M (2012) Acinetobacter lwoffii peritonitis in a patient receiving continuous ambulatory peritoneal dialysis. Ther Apher Dial 17:117–119. https://doi.org/10.1111/j.1744-9987.2012.01099.x
Infectious Diseases (2017) Non-fermenting gram-negative bacterium. In: Cohen J, Powderly MJ, Opal S (eds) Infectious Diseases, 4th edn. Elsevier, pp 1217–1218
Ioannou P, Alexakis K, Baliou S, Kofteridis DP (2022) Infective endocarditis by Moraxella species: a systematic review. J Clin Med 11:1854. https://doi.org/10.3390/jcm11071854
Isler B, Kidd TJ, Stewart AG, Harris P, Paterson DL (2020) Achromobacter infections and treatment options. Antimicrob Agents Chemother 64. https://doi.org/10.1128/AAC.01025-20
Li Y, Kawamura Y, Fujiwara N, Naka T, Liu H, Huang X, Kobayashi K, Ezaki T (2004) Sphingomonas yabuuchiae sp. nov. and Brevundimonas nasdae sp. nov., isolated from the russian space laboratory mir. Int J Syst Evol Microbiol 54:819–825. https://doi.org/10.1099/ijs.0.02829-0
Liu X, Ecarnot M, Kontro MH (2015) The physicochemical conditions of isolation source determine the occurrence of Pseudomonas fluorescens group species. Ann Microbiol 65:2363–2377. https://doi.org/10.1007/s13213-015-1078-1
Marion-Sanchez K, Pailla K, Olive C, Le Coutour X, Derancourt C (2019) Achromobacter spp. healthcare associated infections in the french West Indies: a longitudinal study from 2006 to 2016. BMC Infect Dis 19:795. https://doi.org/10.1186/s12879-019-4431-3
Rakitin AL, Ermakova AY, Beletsky AV, Petrova M, Mardanov AV, Ravin NV (2021) Genome analysis of Acinetobacter lwoffii strains isolated from permafrost soils aged from 15 thousand to 1.8 million years revealed their close relationships with present-day environmental and clinical isolates. Biol 10:871. https://doi.org/10.3390/biology10090871
Ryan MP, Pembroke JT (2018) Brevundimonas spp: emerging global opportunistic pathogens. Virulence 9:480–493. https://doi.org/10.1080/21505594.2017.1419116
Said M, Mitton B, Skosana L, Kopotsa K, Naidoo R, Amutenya V (2022) Outbreak and control of Achromobacter denitrificans at an academic hospital in Pretoria, South Africa. Infect Control Hosp Epidemiol 44:24–30. https://doi.org/10.1017/ice.2022.52
Shyamkuwar A, Deogade N, Wadher B, Roychoudhury K (2014) Incidence of non-fermenter Moraxella species in clinical isolates. Int J Pharm Sci Rev Res 29:105–109
Staradumskyte D, Paulauskas A (2014) Non-fermentative gram-negative bacteria in drinking water. J Water Resource Prot 06:114–119. https://doi.org/10.4236/jwarp.2014.62016
Stojek NM, Szymańska J, Dutkiewicz J (2008) Gram-negative bacteria in water distribution systems of hospitals. Ann Agric Environ Med 15:135–142
Tas MY, Oguz MM, Ceri M (2017) Acinetobacter lwoffii peritonitis in a patient on automated peritoneal dialysis: a case report and review of the literature. Case Rep Nephrol 2017:e5760254. https://doi.org/10.1155/2017/5760254
Vincenti S, Quaranta G, De Meo C, Bruno S, Ficarra MG, Carovillano S, Ricciardi W, Laurenti P (2014a) Non-fermentative gram-negative bacteria in hospital tap water and water used for haemodialysis and bronchoscope flushing: prevalence and distribution of antibiotic resistant strains. Sci Total Environ 499:47–54. https://doi.org/10.1016/j.scitotenv.2014.08.041
Vincenti S, Quaranta G, De Meo C, Raponi M, Bruno S, Ficarra MG, Carovillano S, Ricciardi W, Laurenti P (2014b) Non fermentative gram negative bacteria in hospital water sources: prevalence and distribution of antibiotic resistant strains. Eur J Public Health 24. https://doi.org/10.1093/eurpub/cku162.076
Whistler T, Sangwichian O, Jorakate P, Sawatwong P, Surin U, Piralam B, Thamthitiwat S, Promkong C, Peruski LF (2019) Identification of gram negative non-fermentative bacteria: how hard can it be? PLoS Negl Trop Dis 13:e0007729–e0007729. https://doi.org/10.1371/journal.pntd.0007729
Wong V, Levi K, Baddal B, Turton J, Boswell TC (2011) Spread of Pseudomonas fluorescens due to contaminated drinking water in a bone marrow transplant unit: table 1. J Clin Microbiol 49:2093–2096. https://doi.org/10.1128/jcm.02559-10
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SAF performed the collection of water samples, culturing of selective media, provided the images for the figures, and was responsible for monetary expenses. SMA designed the research proposal, wrote the manuscript, and analyzed the results. SIA edited the manuscript. All authors have read and approved the manuscript.
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Ali, S.M., Fadhl, S.A. & Ali, S.I. Potential sources of water contamination in Sulaymaniyah city hospitals: isolation and identification of non-fermentative gram-negative bacteria. Biologia 78, 3737–3743 (2023). https://doi.org/10.1007/s11756-023-01537-w
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DOI: https://doi.org/10.1007/s11756-023-01537-w