Journal of Microbiology and Biotechnology

The Korean Society for Microbiology and Biotechnology (한국미생물·생명공학회)
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Profiling Total Viable Bacteria in a Hemodialysis Water Treatment System

  • Chen, Lihua (Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences,) ;
  • Zhu, Xuan (Department of Nephrology, No. 2 Hospital in Xiamen) ;
  • Zhang, Menglu (Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences,) ;
  • Wang, Yuxin (Department of Nephrology, No. 2 Hospital in Xiamen) ;
  • Lv, Tianyu (Department of Nephrology, No. 2 Hospital in Xiamen) ;
  • Zhang, Shenghua (Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences,) ;
  • Yu, Xin (Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences,)
  • Received : 2016.12.12
  • Accepted : 2017.03.09
  • Published : 2017.05.28
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Abstract

Culture-dependent methods, such as heterotrophic plate counting (HPC), are usually applied to evaluate the bacteriological quality of hemodialysis water. However, these methods cannot detect the uncultured or viable but non-culturable (VBNC) bacteria, both of which may be quantitatively predominant throughout the hemodialysis water treatment system. Therefore, propidium monoazide (PMA)-qPCR associated with HPC was used together to profile the distribution of the total viable bacteria in such a system. Moreover, high-throughput sequencing of 16S rRNA gene amplicons was utilized to analyze the microbial community structure and diversity. The HPC results indicated that the total bacterial counts conformed to the standards, yet the bacteria amounts were abruptly enhanced after carbon filter treatment. Nevertheless, the bacterial counts detected by PMA-qPCR, with the highest levels of $2.14{\times}10^7copies/100ml$ in softener water, were much higher than the corresponding HPC results, which demonstrated the occurrence of numerous uncultured or VBNC bacteria among the entire system before reverse osmosis (RO). In addition, the microbial community structure was very different and the diversity was enhanced after the carbon filter. Although the diversity was minimized after RO treatment, pathogens such as Escherichia could still be detected in the RO effluent. In general, both the amounts of bacteria and the complexity of microbial community in the hemodialysis water treatment system revealed by molecular approaches were much higher than by traditional method. These results suggested the higher health risk potential for hemodialysis patients from the up-to-standard water. The treatment process could also be optimized, based on the results of this study.

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References

  1. Taleshi MSA, Azimzadeh HR, Ghaneian MT, Namayandeh SM. 2015. Performance evaluation of reverse osmosis systems for water treatment required of hemodialysis in Yazd educational hospitals, 2013. J. Res. Environ. Health 1: 95-103.
  2. Harding GB, Klein E, Pass T, Wright R, Million C. 1990. Endotoxin and bacterial contamination of dialysis center water and dialysate; a cross sectional survey. Int. J. Artif. Organs 13: 39-43. https://doi.org/10.1177/039139889001300107
  3. Wang XF, Lv ZM, Huang J. 2013. Study of the clinical characteristics and related risk factors of nosocomial infections in patients with chronic renal failure receiving hemodialysis. Chin. J. Nosocomiol. 23: 5689-5691.
  4. Zhang C, Liu WJ, Zhang ML, Sun W, Tian F, Chang FF, et al. 2013. Water purification and related standards for dialysis water: a review of recent studies. J. Environ. Health 30: 81-84.
  5. Association for the Advancement of Medical Instrument (AAMI). 2008. Water treatment equipment for hemodialysis applications, ANSI/AAMI RD62: 2006.
  6. Ding L, Su X, Yokota A. 2011. Research progress of VBNC bacteria -a review. Acta Microbiol. Sin. 51: 858-862.
  7. Mizunoe Y, Wai SN, Ishikawa T, Takade A, Yoshida S. 2000. Resuscitation of viable but nonculturable cells of Vibrio parahaemolyticus induced at low temperature under starvation. FEMS Microbiol. Lett. 186: 115-120. https://doi.org/10.1111/j.1574-6968.2000.tb09091.x
  8. Wang YY, Claeys L, Ha DVD, Verstraete W, Boon N. 2010. Effects of chemically and electrochemically dosed chlorine on Escherichia coli and Legionella beliardensis assessed by flow cytometry. Appl. Microbiol. Biotechnol. 87: 331-341. https://doi.org/10.1007/s00253-010-2526-2
  9. Liu Y, Wang C, Tyrrell G, Hrudey SE, Li XF. 2009. Induction of Escherichia coli O157:H7 into the viable but non-culturable state by chloraminated water and river water, and subsequent resuscitation. Environ. Microbiol. Rep. 1: 155-161. https://doi.org/10.1111/j.1758-2229.2009.00024.x
  10. Rao NV, Shashidhar R, Bandekar JR. 2014. Induction, resuscitation and quantitative real-time polymerase chain reaction analyses of viable but nonculturable Vibrio vulnificus, in artificial sea water. World J. Microbiol. Biotechnol. 30: 2205- 2212. https://doi.org/10.1007/s11274-014-1640-1
  11. Slimani S, Robyns A, Jarraud S, Jarraud S, Molmeret M, Dusserre E, et al. 2012. Evaluation of propidium monoazide (PMA) treatment directly on membrane filter for the enumeration of viable but non cultivable Legionella, by qPCR. J. Microbiol. Methods 88: 319-321. https://doi.org/10.1016/j.mimet.2011.12.010
  12. Petti CA, Polage CR, Schreckenberger P. 2005. The role of 16S rRNA gene sequencing in identification of microorganisms misidentified by conventional methods. J. Clin. Microbiol. 43: 6123-6125. https://doi.org/10.1128/JCM.43.12.6123-6125.2005
  13. Carter J . 1996. Evaluation of r ecovery filters f or u se in bacterial retention testing of sterilizing-grade filters. PDA J. Pharm. Sci. Technol. 50: 147-153.
  14. Gomila M, Gasco J, Gil J, Bernabeu R, Lnigo V, Lalucat J. 2006. A molecular microbial ecology approach to studying hemodialysis water and fluid. Kidney Int. 70: 1567-1576. https://doi.org/10.1038/sj.ki.5001756
  15. Zhang S, Ye C, Lin H, Lv L, Yu X. 2015. UV disinfection induces a VBNC state in Escherichia coli and Pseudomonas aeruginosa. Environ. Sci. Technol. 49: 7502-7503. https://doi.org/10.1021/acs.est.5b01681
  16. Nocker A, Mazza A, Masson L, Camper AK, Brousseau R. 2009. Selective detection of live bacteria combining propidium monoazide sample treatment with microarray technology. J. Microbiol. Methods 76: 253-261. https://doi.org/10.1016/j.mimet.2008.11.004
  17. Barbau-Piednoir E, Lievens A, Mbongolo-Mbella G, Roosens N, Sneyers M, Leunda-Casi A, Van den Bulcke M. 2010. SYBR${(R)}$ Green qPCR screening methods for the presence of "35S promoter" and "NOS terminator" elements in food and feed products. Eur. Food Res. Technol. 230: 383-393. https://doi.org/10.1007/s00217-009-1170-5
  18. Caporaso JG, Lauber CL, Walters WA, Berg-Lyons D, Huntley J, Fierer N, et al. 2012. Ultra-high-throughput microbial community analysis on the Illumina HiSeq and MiSeq platforms. ISME J. 6: 1621-1624. https://doi.org/10.1038/ismej.2012.8
  19. Caporaso JG, Kuczynski J, Stombaugh J, Bittinger K, Bushman FD, Costello EK, et al. 2010. QIIME allows analysis of high-throughput community sequencing data. Nat. Methods 7: 335-336. https://doi.org/10.1038/nmeth.f.303
  20. Desantis TZ, Hugenholtz P, Larsen N, Rojas M, Brodie EL, Keller K, et al. 2006. Greengenes, a chimera-checked 16S rRNA gene database and workbench compatible with ARB. Appl. Environ. Microbiol. 72: 5069-5072. https://doi.org/10.1128/AEM.03006-05
  21. Pontoriero G, Pozzoni P, Andrulli S, Locatelli F. 2003. The quality of dialysis water. Nephrol. Dial. Transplant. 21: vii21- vii25.
  22. Tong KH, Wang W, Kwan TH, Chan L, AU TC. 2001. Water treatment for hemodialysis. Hong Kong J. Nephrol. 3: 7-14 https://doi.org/10.1016/S1561-5413(09)60050-8
  23. Miltner RJ, Summers RS, Wang JZ. 1995. Biofiltration performance: Part 2, effect of backwashing. J. Am. Water Works Assoc. 87: 64-70.
  24. Junglee NA, Rahman SU, Wild M, Wilms A, Hirst S, Jibani M, Seale JR. 2010. When pure is not so pure: chloraminerelated hemolytic anemia in home hemodialysis patients. Hemodial. Int. 14: 327-332. https://doi.org/10.1111/j.1542-4758.2010.00454.x
  25. Mezule L, Juhna T. 2016. Effect of labile organic carbon on growth of indigenous Escherichia coli in drinking water biofilm. Chem. Eng. Trans. 49: 619-624.
  26. Smeets ED, Kooman J, Sande FVD, Stobberingh E, Frederik P, Claessens P, et al. 2003. Prevention of biofilm formation in dialysis water treatment systems. Kidney Int. 63: 1574-1576. https://doi.org/10.1046/j.1523-1755.2003.00888.x
  27. Man NK, Degremont A, Darbord JC, Collet M, Vaillant P. 1998. Evidence of bacterial biofilm in tubing from hydraulic pathway of hemodialysis system. Artif. Organs 22: 596-600. https://doi.org/10.1046/j.1525-1594.1998.06195.x
  28. Flemming HC, Percival SL, Walker J. 2002. Contamination potential of biofilms in water distribution systems. Water Res. 2: 271-280.
  29. Daneshian M, Wendel AT, Von-Aulock S. 2008. High sensitivity pyrogen testing in water and dialysis solutions. J. Immunol. Methods 336: 64-70. https://doi.org/10.1016/j.jim.2008.03.013
  30. Mangram AJ, Archibald LK, Hupert M, Tokars JI, Sliver TL, Brennan P, et al. 1998. Outbreak of sterile peritonitis among continuous cycling peritoneal dialysis patients. Kidney Int. 54: 1367-1371. https://doi.org/10.1046/j.1523-1755.1998.00110.x
  31. Penne EL, Visser L, Dorpel MAVD, Weerd NCVD, Mazairac AHA, Jaarsveld BCV, et al. 2009. Microbiological quality and quality control of purified water and ultrapure dialysis fluids for online hemodiafiltration in routine clinical practice. Kidney Int. 76: 665. https://doi.org/10.1038/ki.2009.245
  32. Lu JX, Ding F, Lu FM. 2004. Analysis of microbial contamination in dialysis water and dialysate of five dialysis centers in shanghai. Shanghai Med. J. 46: 111-134.
  33. Revetta RP, Pemberton A, Lamendella R, Lker B, Santo Domingo JW. 2010. Identification of bacterial populations in drinking water using 16S rRNA-based sequence analyses. Water Res. 44: 1353-1360. https://doi.org/10.1016/j.watres.2009.11.008
  34. Dalpke A, Frank J, Peter M, Heeg K. 2006. Activation of Toll-like receptor 9 by DNA from different bacterial species. Infect. Immun. 74: 940-946. https://doi.org/10.1128/IAI.74.2.940-946.2006
  35. Verthelyi D, Ishii KJ, Gursel M, Takeshita F, Klinman DM. 2001. Human peripheral blood cells differentially recognize and respond to two distinct CPG motifs. J. Immunol. 166: 2372-2377. https://doi.org/10.4049/jimmunol.166.4.2372
  36. Stoodley P, Sauer K, Davies DG, Costerton JW. 2002. Biofilm as complex differentiated communities. Annu. Rev. Microbiol. 56: 187-209. https://doi.org/10.1146/annurev.micro.56.012302.160705
  37. Wilks SA, Giao MS, Keevil CW. 2013. Comparison of methods for the detection of culturable and VBNC Escherichia coli O157:H7 in complex drinking water biofilms, pp. 243-249. In Borchers U, Gray J, Clive Thompson K (eds.). Water Contamination Emergencies: Managing the Threats. Royal Society of Chemistry Publishing, Cambridge, UK.
  38. Gomila M, Gasco J, Busquets A, Gil J, Bernabeu R, Buades JM, et al. 2005. Identification of culturable bacteria present in haemodialysis water and fluid. FEMS Microbiol. Ecol. 52: 101-114. https://doi.org/10.1016/j.femsec.2004.10.015
  39. Devraj A, Siva TPV, Biswal M, Ramachandran R, Jha V. 2016. Extranasal Staphylococcus aureus colonization predisposes to bloodstream infections in patients on hemodialysis with noncuffed internal jugular vein catheters. Hemodial. Int. 21: 35-40.
  40. Saxena AK, Panhotra BR, Chopra R. 2004. Advancing age and the risk of nasal carriage of Staphylococcus aureus among patients on long-term hospital-based hemodialysis. Ann. Saudi Med. 24: 337-342. https://doi.org/10.5144/0256-4947.2004.337

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