1. Pseudomonas aeruginosadose response and bathing water infection
- Author
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Scott A. Rice, Charles N. Haas, S. Boase, Nicholas J. Ashbolt, B. van den Akker, D.J. Roser, School of Biological Sciences, and Singapore Centre for Environmental Life Sciences Engineering
- Subjects
Hot Temperature ,Epidemiology ,Science::Biological sciences::Molecular biology [DRNTU] ,Folliculitis ,Review Article ,Disease ,medicine.disease_cause ,Disease Outbreaks ,Microbiology ,Swimming Pools ,Acute otitis externa ,Humans ,Medicine ,Pseudomonas Infections ,Colonization ,Pathogen ,Bathing water ,business.industry ,Pseudomonas aeruginosa ,Outbreak ,Hygiene ,Skin Diseases, Bacterial ,medicine.disease ,Infectious Diseases ,Immunology ,Water Microbiology ,business - Abstract
SUMMARYPseudomonas aeruginosais the opportunistic pathogen mostly implicated in folliculitis and acute otitis externa in pools and hot tubs. Nevertheless, infection risks remain poorly quantified. This paper reviews disease aetiologies and bacterial skin colonization science to advance dose-response theory development. Three model forms are identified for predicting disease likelihood from pathogen density. Two are based on Furumoto & Mickey's exponential ‘single-hit’ model and predict infection likelihood and severity (lesions/m2), respectively. ‘Third-generation’, mechanistic, dose-response algorithm development is additionally scoped. The proposed formulation integrates dispersion, epidermal interaction, and follicle invasion. The review also details uncertainties needing consideration which pertain to water quality, outbreaks, exposure time, infection sites, biofilms, cerumen, environmental factors (e.g. skin saturation, hydrodynamics), and whetherP. aeruginosais endogenous or exogenous. The review's findings are used to propose a conceptual infection model and identify research priorities including pool dose-response modelling, epidermis ecology and infection likelihood-based hygiene management.
- Published
- 2013