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Characteristics of Pseudomonas aeruginosa isolated from whirlpools and bathers
Abstract:
Pseudomonas aeruginosa is the most frequently isolated microorganism from whirlpool water and lesions associated with outbreaks of dermatitis and folliculitis related to whirlpool exposure. Strains were selected from 19 outbreaks of P. aeruginosa infections (1977 to 1983) associated with whirlpool use; they were examined to determine if the strains possessed unique virulence factors or characteristics that might aid in their selection in the environment. P. aeruginosa, 011, was the predominant serotype isolated from whirlpool water as well as from bathers with dermatitis or folliculitis, followed by serotypes 09, 04, and 03. Antimicrobial susceptibility patterns were similar for all strains. Strains of P. aeruginosa from bathers and water demonstrated statistically significant differences in extracellular enzyme production compared with control strains. P. aeruginosa, serotypes 09 and 011, were found to be sensitive to low levels of chlorine. These data suggest that, if adequate levels of free available chlorine are maintained, P. aeruginosa should have little opportunity to persist in whirlpools. A bather's risk of P. aeruginosa dermatitis or folliculitis appears to be affected primarily by three factors: immersion in water colonized by P. aeruginosa, skin hydration with altered skin flora, and toxic reactions to extracellular enzyme or exotoxins produced by P. aeruginosa. Although a single virulence factor was not identified from the results of this study, there are some indications that the enzymes produced by these microorganisms play an important role in the pathogenesis of disease associated with whirlpool use.
Insights
Pseudomonas aeruginosa outbreaks in whirlpools are linked to specific serotypes and increased enzyme production. Maintaining adequate chlorine levels can prevent Pseudomonas aeruginosa persistence and reduce bathers' risk of dermatitis.
Area of Science:
- Microbiology
- Environmental Health
- Dermatology
Background:
- Pseudomonas aeruginosa is frequently found in whirlpools and linked to skin infections.
- Outbreaks of dermatitis and folliculitis have been associated with whirlpool use.
Purpose of the Study:
- To investigate virulence factors of Pseudomonas aeruginosa strains from whirlpool outbreaks.
- To determine if specific serotypes or characteristics aid environmental persistence.
- To assess the role of extracellular enzymes in pathogenesis.
Main Methods:
- Analysis of P. aeruginosa strains from 19 whirlpool-associated outbreaks (1977-1983).
- Serotyping of isolates and comparison with environmental strains.
- Assessment of extracellular enzyme production.
- Antimicrobial susceptibility testing.
- Chlorine sensitivity testing.
Main Results:
- Serotypes 011, 09, 04, and 03 were predominant in whirlpools and infections.
- Strains from bathers and water showed significant differences in enzyme production compared to controls.
- Serotypes 09 and 011 were sensitive to low chlorine levels.
- No single virulence factor was definitively identified.
Conclusions:
- Adequate free available chlorine levels are crucial for preventing Pseudomonas aeruginosa persistence in whirlpools.
- Bather risk is influenced by water colonization, skin condition, and microbial toxins.
- Extracellular enzymes likely play a role in the pathogenesis of whirlpool-associated skin infections.