Opportunistic Premise Plumbing Pathogens: Increasingly Important Pathogens in Drinking Water

Area of Science:

• Environmental microbiology
• Public health microbiology
• Waterborne disease epidemiology

Background:

• Opportunistic premise plumbing pathogens (OPPPs) are increasingly identified as a source of drinking water-related infections.
• These pathogens pose a significant public health concern, contributing to an estimated annual economic cost of at least $1 billion.
• OPPPs share common traits including disinfectant resistance, biofilm formation, and the ability to thrive in low-nutrient, low-oxygen environments.

Purpose of the Study:

• To highlight the emerging threat of opportunistic premise plumbing pathogens in drinking water systems.
• To identify the key characteristics of OPPPs that facilitate their proliferation in plumbing environments.
• To underscore the need for novel control strategies to mitigate human exposure to these waterborne pathogens.

Main Methods:

• Literature review and synthesis of existing research on opportunistic premise plumbing pathogens.
• Analysis of common features and survival mechanisms of OPPPs within drinking water distribution systems.
• Examination of the role of drinking water treatment processes in selecting for OPPPs.

Main Results:

• Opportunistic premise plumbing pathogens are a significant cause of infections linked to drinking water.
• Key traits enabling pathogen survival include disinfectant resistance, biofilm formation, growth in amoebae, and adaptation to low organic matter and oxygen levels.
• Drinking water treatment conditions inadvertently select for these resilient opportunistic pathogens.

Conclusions:

• Novel approaches are essential to reduce human exposure to opportunistic premise plumbing pathogens.
• Control measures can be implemented by water utilities, building operators, and homeowners.
• Further research and proactive control strategies are crucial to address this growing waterborne disease challenge.