Adherence and biofilm formation of Mycobacterium avium, Mycobacterium intracellulare and Mycobacterium abscessus to household plumbing materials.

AIMS: Measure adherence and biofilm formation by cells of Mycobacterium avium, Mycobacterium intracellulare and Mycobacterium abscessus on common household plumbing materials namely stainless steel, glass, zinc-galvanized steel, copper and polyvinyl chloride (PVC). METHODS AND RESULTS: Coupons in a CDC biofilm reactor were exposed to cell suspensions containing 10(5) NTM colony forming units (CFU) per ml and adherence measured for 6 h. Biofilm formation (increased numbers of adherent CFU) was measured weekly to 21 days in the absence of substantial numbers of suspended mycobacterial cells. Adherence was rapid and substantial with 2000-15 000 CFU cm(-2) adhering within 1-6 h at room temperature. Biofilm numbers reached as high as 10(7)  CFU cm(-2) . Biofilm-grown cells of Myco. avium were more adherent compared with suspension-grown cells. CONCLUSIONS: Mycobacterium avium, Myco. intracellulare and Myco. abscessus readily adhered and formed biofilms on all types of plumbing materials. Factors influencing adherence and biofilm formation were species, plumbing material and prior growth.

Antimicrobial activity of cuprous oxide-coated and cupric oxide-coated surfaces.

BACKGROUND: Disease can be spread through contact with contaminated surfaces (fomites). For example, fomites have been implicated in the spread of meticillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa. Antimicrobial surface treatments are a potential method of reducing disease transmission from fomites, and broad-spectrum activity is desirable. AIM: To test cuprous oxide (Cu2O) and cupric oxide (CuO) coatings for antimicrobial activity against 12 micro-organisms including bacteria and fungi. METHODS: We fabricated two surface coatings. The Cu2O coating was fabricated in a simple two-step process using polyurethane to bind the active copper oxide particles; CuO was prepared by heat treatment of Cu2O particles in air to produce cupric oxide (CuO) and to cause early-stage sintering to form a continuous coating. The antimicrobial activity was examined with 10 µL of microbial suspension droplets followed by counting cells as colony-forming units (cfu). FINDINGS: The coatings rapidly killed nine different micro-organisms, including Gram-negative and Gram-positive bacteria, mycobacteria and fungi. For example, the Cu2O/PU coating killed 99.9997% of P. aeruginosa and 99.9993% of S. aureus after 1 h. Efficacy was not reduced after weekly cleanings. The antimicrobial activity of the Cu2O coating was unchanged after abrasion treatment, and the coatings were not cytotoxic to human cells. CONCLUSION: The combination of broad-spectrum antimicrobial activity, abrasion resistance, and low toxicity of the Cu2O coating suggests potential use in healthcare settings.

Disinfection and cleaning of heater-cooler units: suspension- and biofilm-killing.

BACKGROUND: Non-tuberculous mycobacteria (NTM) infections in cardiac surgery patients, caused by Mycobacterium chimaera or Mycobacterium abscessus, have been traced to NTM-aerosols produced by heater-cooler units of cardiopulmonary bypass equipment. AIM: To develop a protocol to disinfect the water reservoir(s) of heater-coolers to reduce NTM numbers and thereby prevent potential NTM aerosolization; and to devise an approach to disrupt surface biofilms of heater-coolers to reduce reinoculation of the heater-cooler reservoir(s) after disinfection. METHODS: A laboratory-scale Centers for Disease Control and Prevention bioreactor and a heater-cooler were inoculated with M. chimaera or M. abscessus to measure the ability of different disinfection protocols to reduce NTM colony-forming units in water and biofilm samples and to delay the reappearance of NTM after disinfection. FINDINGS: The combination of an enzyme detergent cleaning agent and Clorox® were equivalent to Clorox alone in reducing M. chimaera cfu in heater-cooler water reservoir samples. However, reappearance of those bacteria was delayed by 12 weeks by the combination of enzyme detergent cleaning agent and Clorox exposure compared to Clorox disinfection alone. CONCLUSION: A combination of an enzyme detergent and Clorox was an effective disinfection treatment and significantly delayed the reappearance of M. chimaera in the heater-cooler reservoir.

Surrounded by mycobacteria: nontuberculous mycobacteria in the human environment.

A majority of the Mycobacterium species, called the nontuberculous mycobacteria (NTM), are natural inhabitants of natural waters, engineered water systems, and soils. As a consequence of their ubiquitous distribution, humans are surrounded by these opportunistic pathogens. A cardinal feature of mycobacterial cells is the presence of a hydrophobic, lipid-rich outer membrane. The hydrophobicity of NTM is a major determinant of aerosolization, surface adherence, biofilm-formation, and disinfectant- and antibiotic resistance. The NTM are oligotrophs, able to grow at low carbon levels [>50 microg assimilable organic carbon (AOC) l(-1)], making them effective competitors in low nutrient, and disinfected environments (drinking water). Biofilm formation and oligotrophy lead to survival, persistence, and growth in drinking water distribution systems. In addition to their role as human and animal pathogens, the widespread distribution of NTM in the environment, coupled with their ability to degrade and metabolize a variety of complex hydrocarbons including pollutants, suggests that NTM may be agents of nutrient cycling.

Microbial-mediated release of bisphenol A from polycarbonate vessels.

AIM: To identify the source of bisphenol A (BPA) [2,2'-bis(4-hydroxyphenyl) propane] in cultures of an antibiotic-producing Bacillus sp. strain grown in polycarbonate flasks. METHODS AND RESULTS: Although a culture of an antibiotic-producing Bacillus sp. strain grown in a new, rinsed polycarbonate flask yielded BPA, duplicate cultures grown in thoroughly washed polycarbonate flasks did not. Cells of Escherichia coli strain C were grown in new polycarbonate flasks rinsed three-times with 100 ml distilled H2O. BPA was only recovered from cultures grown in new polycarbonate flasks, but not from the autoclaved medium incubated in parallel. CONCLUSIONS: BPA was present in either Bacillus or E. coli cultures, probably due to its release from inadequately washed polycarbonate flasks. Standard autoclaving did not result in BPA appearance; microbial growth was required. Polycarbonate vessels for microbial cultures should be thoroughly washed to avoid the appearance of BPA in culture medium. SIGNIFICANCE AND IMPACT OF THE STUDY: This study rigorously demonstrates that the presence of BPA in culture medium was a consequence of microbial growth or metabolism in inadequately washed polycarbonate flasks. As BPA exhibits antimicrobial and oestrogenic activity, searches for novel drugs or production of recombinant chemotherapeutic agents could be derailed by the artefactual appearance of BPA.

Genetic analysis of a double male strain of Escherichia coli K12.

The behavior of a double male strain of Escherichia coli K12 has been compared to that of its parents and a primary F' strain carrying F14 in order to determine whether the genome of the double male, responsible for the double origin mode of gene transmission, is composed of one or two linkage groups. F-prime plasmids carrying leu and pyrB and argG and metC have been detected following mating an F(-)recA(-) recipient with the double male. Their existence strongly supports the contention that the double male is composed of a single linkage group with two integrated sex factors. Data from acridine orange curing experiments places the frequency of double male cells in the population of growing cells in the two-chromosome configuration as less than one percent. Evidence for a unique origin and terminus of DNA replication deduced by the density labelling and transduction of double male DNA supports the contention that the double male is best considered a cell with a single chromosome carrying two integrated F plasmids.

The international epidemiology of disseminated Mycobacterium avium complex infection in AIDS. International MAC Study Group.

OBJECTIVE: To determine rates of disseminated Mycobacterium avium complex (MAC) infection among AIDS patients in developed and developing countries, and to determine whether different rates reflect differences in exposure or immunity, or both. DESIGN: Prospective cohort study. SETTING: University hospitals and outpatient AIDS programs. METHODS: HIV-infected subjects with CD4 counts < 200 x 10(6)/l were interviewed and had CD4 lymphocyte counts, blood cultures for mycobacteria (baseline and at 6 months), and skin tests with purified protein derivative (PPD) and M. avium sensitin. RESULTS: Among 566 study patients rates of disseminated MAC were 10.5-21.6% in New Hampshire, Boston and Finland compared to 2.4-2.6% in Trinidad and Kenya (P < 0.001). PPD skin test reactions > or = 5 mm were present in 20% of patients from Kenya compared to 1% at other sites (P < 0.001). Among patients from the United States and Finland, multiple logistic regression indicated that occupational exposure to soil and water was associated with a decreased risk of disseminated MAC, whereas the following were associated with an increased risk of disseminated MAC: low CD4 count, swimming in an indoor pool, history of bronchoscopy, regular consumption of raw or partially cooked fish/shellfish and treatment with granulocyte colony-stimulating factor. CONCLUSIONS: Rates of disseminated MAC in AIDS are higher in developed than developing countries and are due to both differences in exposure and differences in immunity. These data provide a rationale for prevention of MAC through both active immunization and reduction in exposure to the organism.

Absence of Mycobacterium avium complex disease in patients with AIDS in Uganda.

The absence of disease due to Mycobacterium avium in Ugandan patients with AIDS, which we previously observed in a blood culture study, has been confirmed and our observations have been extended to 165 additional clinical isolates. Fourteen soil and water samples from the Ugandan environment have been cultured and revealed a high frequency of isolation of M. avium. The absence of M. avium complex disease in Uganda remains unexplained.

Isolation of restriction fragments from large plasmids recovered from bacteria with multiple plasmids.

A rapid and simple method for isolation of restriction DNA fragments from large plasmids is described. The loss of large plasmids is avoided by restriction endonuclease cleavage in an agarose gel before DNA precipitation. Plasmids were separated in low-melting-point agarose by electrophoresis, the desired plasmid DNA band was cut from the gel and digested with a restriction endonuclease in the agarose. Restriction fragments in agarose were recovered by a modified phenol-extraction, concentrated with 2-butanol and precipitated with ethanol. The procedure simplifies the task of cloning genes from large plasmids, resulting in high yields of restriction fragments from a desired plasmid in a short time.

Rapid coliphage detection assay.

A rapid coliphage detection assay was developed, based on the phage-induced release of beta-galactosidase from cells of Escherichia coli. The assay could detect as few as five coliphage per sample without an overnight incubation period. The range of acceptable assay parameters was identified.

A liquid, colorimetric presence-absence coliphage detection method.

A liquid, colorimetric presence-absence coliphage detection method based on the induction of beta-galactosidase by Escherichia coli is described. The release of beta-galactosidase in the medium due to lytic cell infections by coliphages permits the hydrolysis of a yellow chromogenic substrate that develops into a distinct red coliphage positive sample, while a coliphage negative sample remains yellow. This method has proven to be rapid, simpler to perform than an agar medium assay, easy to read and interpret, inexpensive, and highly sensitive.

A luciferase-based method for assessing chlorine-susceptibility of Mycobacterium avium.

A rapid and quantitative assay for the disinfection of the water-borne pathogen, Mycobacterium avium, was developed using firefly luciferase as a reporter gene. There was a correlation between the quantity of light produced and the number of colony-forming units. In chlorine-disinfection studies of a luciferase-carrying derivative of M. avium, there was a strong correlation (r2=0.96) between colony forming units and relative light units. It was discovered that chlorine was rapidly lost from suspensions containing 10(6) M. avium cells/ml. The luciferase-based test can be used to rapidly measure susceptibility of M. avium to different disinfectants used in water treatment.

High rates of disseminated infection due to non-tuberculous mycobacteria among AIDS patients in Finland.

OBJECTIVE: to determine the rate of disseminated infection due to non-tuberculous mycobacteria (NTM) among Finnish AIDS patients, and to analyse the epidemiology of these infections. METHODS: in a prospective cohort study HIV-infected patients with CD4 counts < 200 x 10(6)/l were interviewed, and had mycobacterial blood cultures performed at baseline and at 6 months, then subsequently for clinical indications; autopsies were performed on patients who died. The cohort was followed at least for 24 months or to death. Water samples were collected from the homes of patients and from the environment and cultured for organisms of the Myobacterium avium complex (MAC). Environmental and clinical isolates were compared using pulsed field gel electrophoresis (PFGE). RESULTS: NTM infection occurred in 22 (43%) of 51, 19 isolates were Mycobacterium avium, two M. genavense and one M. intracellulare. Multivariate analysis identified urban residence (P=0.04) and eating raw fish (P=0.04) as independent risk factors. Molecular analysis revealed two clusters of related isolates (three M. avium, two M. genavense) among urban residents. CONCLUSION: AIDS patients in Finland have high rates of disseminated infection due to NTM. Clusters of identical organisms and association with urban residence suggests that these are newly acquired infections in advanced AIDS.

Gene lon and plasmid inheritance in Escherichia coli K-12.

Lon- mutants of Escherichia coli K-12 are deficient in the inheritance of F-plasmids by conjugation. This deficiency is distinct from the conjugation deficiency caused by overproduction of capsular polysaccharide which decreases donor-recipient pair formation.