Pathogenic Mycobacteria in Water: A Guide to Public Health Consequences, Monitoring and Management

Contents......Page 6
Preface......Page 12
Acknowledgements......Page 14
Executive Summary......Page 16
List of acronyms and abbreviations......Page 22
1.1 Environmental Mycobacteria......Page 24
1.2 Nomenclature and typing......Page 25
1.3.1 The epidemiology of environmental mycobacteria......Page 28
1.4.1 Water supply......Page 30
1.5 Global Burden of Disease......Page 31
1.5.1 Crohn disease and Johne disease......Page 34
1.7 Genomic and evolutionary perspectives......Page 35
1.8 Key research issues......Page 37
2 Natural ecology and survival in water of mycobacteria of potential public health significance......Page 38
2.1.2 Infections in birds and animals......Page 39
2.1.3 Infections in fish......Page 40
2.2.1 Physiologic characteristics of M. avium that are determinants of its ecology......Page 41
2.2.2 M. avium physiologic ecology......Page 43
2.3.2 M. avium fingerprinting methods......Page 44
2.4.2 Selection of mycobacteria by disinfectants......Page 46
2.5 Key research issues......Page 47
3 Environmental sources of Mycobacterium avium linked to routes of exposure......Page 49
3.1.1 M. avium in water......Page 50
3.1.2 M. avium in soils......Page 53
3.1.3 M. avium in aerosols, ejected droplets and dust......Page 54
3.1.4 M. avium in phagocytic protozoa and amoebae......Page 55
3.1.5 Other sources of M. avium......Page 56
3.3 Environments with high numbers of M. avium......Page 57
3.4.1 Ingestion......Page 58
3.4.4 Biofilms......Page 59
3.6 Key research issues......Page 60
4.1.1 Taxonomy and terminology......Page 62
4.1.2 Evolution and diversity of MAC......Page 64
4.2.1 The MAA genome......Page 66
4.2.2 The MAP genome......Page 69
4.2.3 Genomes of other environmental mycobacteria......Page 70
4.3.2 Morphotypic switches......Page 71
4.3.3 Metabolism and catabolism......Page 73
4.4.2 MAA genes involved in intracellular life......Page 74
4.5.1 Diversity......Page 76
Acknowledgements......Page 77
5.1 Introduction......Page 78
5.2 The analysis process......Page 81
5.2.1 Sampling......Page 83
5.2.3 Sample preparation......Page 84
5.2.4 Detection......Page 86
5.3 Key research issues......Page 96
6.1 Mycobacterium avium subspecies paratuberculosis......Page 97
6.2 MAP infection and Johne disease in domestic livestock......Page 98
6.3 Different strains of MAP......Page 101
6.4 MAP in wildlife and in the environment......Page 102
6.5 Transmission of MAP from animals to humans......Page 103
6.5.1 In food......Page 104
6.5.2 In water supplies and aerosols......Page 105
6.6.1 Definition......Page 106
6.6.2 Epidemiology, environmental factors, and inherited susceptibility to CD......Page 108
6.6.3 The isolated case of Iceland......Page 110
6.7 MAP causing Crohn disease......Page 111
6.7.1 MAP in the inflamed gut of people with Crohn disease......Page 112
6.7.2 Serological recognition of MAP proteins in Crohn disease......Page 114
6.7.3 Response of Crohn disease to treatment with anti-MAP drugs......Page 115
6.7.4 Pathogenic mechanisms of MAP in Crohn disease......Page 116
Acknowledgements......Page 117
7.1.1 Clinical aspects......Page 118
7.1.3 Epidemiology and risk factors......Page 119
7.1.5 Prevention and treatment......Page 121
7.2.1 Clinical aspects......Page 122
7.2.2 Epidemiology and risk factors......Page 123
7.2.5 Prevention and treatment......Page 124
7.4 Osteomyelitis and septic arthritis......Page 125
7.8 Key research issues......Page 126
8 Skin, Bone and Soft Tissue Infections......Page 127
8.1.1 M. marinum......Page 128
8.1.2 Rapidly Growing Mycobacteria......Page 130
8.1.3 Mycobacterium avium complex......Page 131
8.1.4 M. haemophilum......Page 132
8.2 Overall burden of disease......Page 133
8.3 Distribution......Page 134
8.5 Risk factors......Page 135
8.6 Causality and associated microbes......Page 136
8.7 Key research issues......Page 137
9 Pulmonary infection in non-HIV infected individuals......Page 138
9.1 Clinical aspects......Page 139
9.1.1 Primary and secondary pathogenic pulmonary environmental mycobacterial infection......Page 141
9.1.2 Selected treatment issues......Page 147
9.2 Overall burden of disease......Page 149
9.4 Descriptive epidemiology......Page 150
9.6 Risk factors......Page 151
9.7 Prevalence of asymptomatic disease......Page 152
9.8 Key research issues......Page 153
10 Disease Resulting From Contaminated Equipment and Invasive Procedures......Page 154
10.1.1 General comments......Page 155
10.1.2 Specific infections......Page 158
10.1.3 Selected microbial factors......Page 162
10.2 Overall burden of disease......Page 163
10.6 Causality and associated microbes......Page 164
10.7 Key research issues......Page 165
11.1 Introduction......Page 166
11.2.1 Physical removal by coagulation and filtration......Page 168
11.2.2 Disinfection......Page 172
11.3.1 Biodegradable organic matter......Page 183
11.3.2 Impact of water contact materials......Page 185
11.4.1 Temperature......Page 187
11.4.2 Control of free living amoebae......Page 188
11.5 Role of distribution system recontamination......Page 189
11.6 Key research issues......Page 190
Acknowledgements......Page 191
12.1 Introduction......Page 192
12.2 Public health response......Page 193
12.3.1 Drinking/bathing water......Page 195
12.3.3 Industrial exposure......Page 197
12.3.5 The high risk groups......Page 198
12.4 The HACCP approach to management......Page 199
12.5 Key research issues......Page 201
References......Page 202
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