Occurrence of Non-tuberculous mycobacteria in UK household showers
PHE ePoster Library. Stevenson D. Apr 9, 2019; 257516; 15431
David Stevenson
David Stevenson
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Abstract
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Abstract Occurrence of Non-tuberculous mycobacteria in UK household showersStevenson D, Collins S, Bennett ABiosafety, Air and Water Microbiology Group,NIS,PHE,Porton Down, UKBackground Inhalation of non-tuberculous mycobacteria(NTM) can cause severe pulmonary disease.Household water systems have been proposed as a potential source of NTM infection and showers represent a frequently used potential source of infectious aerosols in the domestic setting. However,little is known about the occurrence and/or diversity of NTM in UK water systems.This study investigated the prevalence of NTM in UK household showers.
Methods:
Volunteers were asked to take a sample of water(1L) dispensed from their domestic shower(s) and if possible,a swab sample from inside the shower hose.Samples were returned to the laboratory and tested according to traditional culture methods and by qPCR for the presence of NTM. Active air sampling,using an Andersen air sampler,was carried out to investigate the presence of NTM in the aerosols generated during showering..
Results:
Ninety-nine showers from 82 separate properties in the South of England were sampled. NTM were cultured from 71% of shower water samples; 94% of samples were positive for NTM by qPCR.Air samples were taken adjacent to two showers.The mean concentration of NTM recovered was 723 CFU/m3(shower A) and 3690 CFU/m3(shower B).In both cases, the highest proportions of NTM were recovered on stages 4 and 5 of the sampler indicating that the majority of particles were between 1 and 3 µm in diameter(i.e. within the respirable range).During this study 21 species of NTM were identified,with M. gordonae,M. chelonae and M. mucogenicum complex being the most prevalent. Conclusion The incidence of NTM pulmonary infection continues to increase. Household showers may be important reservoirs of NTM and should be considered in source investigations.Simple public health advice(e.g. regular cleaning) may help to mitigate the risk of NTM exposure in the domestic shower environment. Funding PHE
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