Shedding of Staphylococcus aureus and methicillin-resistant Staphylococcus aureus from adult and pediatric bathers in marine waters

Epiphytic and endophytic microbiome of the seagrass Zostera marina: Do they contribute to pathogen reduction in seawater?

Seagrass meadows provide crucial ecosystem services for coastal environments and were shown to reduce the abundance of waterborne pathogens linked to infections in humans and marine organisms in their vicinity. Among potential drivers, seagrass phenolics released into seawater have been linked to pathogen suppression, but the potential involvement of the seagrass microbiome has not been investigated. We hypothesized that the microbiome of the eelgrass Zostera marina, especially the leaf epiphytes that are at direct interface between the seagrass host and the surrounding seawater, inhibit waterborne pathogens thereby contributing to their removal. Using a culture-dependent approach, we isolated 88 bacteria and fungi associated with the surfaces and inner tissues of the eelgrass leaves (healthy and decaying) and the roots. We assessed the antibiotic activity of microbial extracts against a large panel of common aquatic, human (fecal) and plant pathogens, and mined the metabolome of the most active extracts. The healthy leaf epibiotic bacteria, particularly Streptomyces sp. strain 131, displayed broad-spectrum antibiotic activity superior to some control drugs. Gram-negative bacteria abundant on healthy leaf surfaces, and few endosphere-associated bacteria and fungi also displayed remarkable activities. UPLC-MS/MS-based untargeted metabolomics analyses showed rich specialized metabolite repertoires with low annotation rates, indicating the presence of many undescribed antimicrobials in the extracts. This study contributes to our understanding on microbial and chemical ecology of seagrasses, implying potential involvement of the seagrass microbiome in suppression of pathogens in seawater. Such effect is beneficial for the health of ocean and human, especially in the context of climate change that is expected to exacerbate all infectious diseases. It may also assist future seagrass conservation and management strategies.

Plastic pollution as a novel reservoir for the environmental survival of the drug resistant fungal pathogen Candida auris

The WHO recently classified Candida auris as a fungal pathogen of "critical concern". Evidence suggests that C. auris emerged from the natural environment, yet the ability of this pathogenic yeast to survive in the natural environment is still poorly understood. The aim of this study, therefore, was to quantify the persistence of C. auris in simulated environmental matrices and explore the role of plastic pollution for facilitating survival and potential transfer of C. auris. Multi-drug resistant strains of C. auris persisted for over 30 days in river water or seawater, either planktonically, or in biofilms colonising high-density polyethylene (HDPE) or glass. C. auris could be transferred from plastic beads onto simulated beach sand, particularly when the sand was wet. Importantly, all C. auris cells recovered from plastics retained their pathogenicity; therefore, plastic pollution could play a significant role in the widescale environmental dissemination of this recently emerged pathogen.

Detection of mecA positive staphylococcal species in a wastewater treatment plant in South Africa

We investigated the prevalence of antibiotic resistant staphylococci and detection of resistant, virulence, and Spa genes in a South African wastewater treatment plant. Species identified were Staphylococcus aureus, S. lentus, S. arlettae, S. cohnii, S. haemolyticus, S. nepalensis, S. sciuri (now Mammaliicoccus sciuri), and S. xylosus. Isolates showed high resistance to methicillin (91%), ampicillin (89%), ciprofloxacin (86%), amoxycillin (80%), ceftazidime (74%), and cloxacillin (71%). Multiple antibiotic resistance (MAR) index for the isolates exceeded 0.2 (0.50-0.70). Among the isolates, 77% were mecA-positive. All S. aureus strains were positive for nuc and 7 Spa gene types. The present study highlights possibility of treated wastewaters being potential reservoir for antibiotic-resistant staphylococci. This is a cause for concern as wastewater effluents are decanted into environmental waters and these are, in many cases, used for various purposes including recreation (full contact), religious (full body submersion), and drinking water for some rural communities and water for livestock.

The presence of antibiotics and multidrug-resistant Staphylococcus aureus reservoir in a low-order stream spring in central Brazil

The disposal of industrial effluents strongly influences low-order streams, which makes them fragile ecosystems that can be impacted by contamination. In central Brazil, the Extrema River spring targets the dumping of pharmaceutical products from the surrounding industries. So, this work aimed to investigate the presence of antibiotics in Extrema River spring samples and the isolation of Staphylococcus aureus, a potential multidrug-resistant bacteria, verifying the antimicrobial resistance profile of these isolates. Three campaigns were carried out in different locals (P1-P3) between October and December 2021, in the dry and rainy seasons. The high-performance liquid chromatography-tandem mass spectrometry (LCMS) approach indicated the presence of sulfamethoxazole (≥ 1 ng/L), metronidazole (< 0.5 ng/L), and chloramphenicol (< 5 ng/L) in the water samples in November (rainy season). S. aureus was isolated in P1 (n = 128), P2 (n = 168), and P3 (n = 36), with greater resistance to trimethoprim-sulfamethoxazole (90%), clindamycin (70%), and gentamicin (60%). The presence of antibiotics in the Extrema River spring may cause S. aureus antibiotic resistance development. The presence of antibiotics and the high percentage of isolated multidrug-resistant S. aureus in the Extrema River spring cause concern and indicate the clandestine dumping of effluents from nearby pharmaceutical industries. Since preserving the springs of low-order streams is important for the environment and public health, we encourage monitoring the wastewater from Extrema River's nearby pharmaceutical industries and preserving the spring of this river.

Urbanization promotes specific bacteria in freshwater microbiomes including potential pathogens

Freshwater ecosystems are characterized by complex and highly dynamic microbial communities that are strongly structured by their local environment and biota. Accelerating urbanization and growing city populations detrimentally alter freshwater environments. To determine differences in freshwater microbial communities associated with urbanization, full-length 16S rRNA gene PacBio sequencing was performed in a case study from surface waters and sediments from a wastewater treatment plant, urban and rural lakes in the Berlin-Brandenburg region, Northeast Germany. Water samples exhibited highly habitat specific bacterial communities with multiple genera showing clear urban signatures. We identified potentially harmful bacterial groups associated with environmental parameters specific to urban habitats such as Alistipes, Escherichia/Shigella, Rickettsia and Streptococcus. We demonstrate that urbanization alters natural microbial communities in lakes and, via simultaneous warming and eutrophication and creates favourable conditions that promote specific bacterial genera including potential pathogens. Our findings are evidence to suggest an increased potential for long-term health risk in urbanized waterbodies, at a time of rapidly expanding global urbanization. The results highlight the urgency for undertaking mitigation measures such as targeted lake restoration projects and sustainable water management efforts.

Monitoring of microbiological dynamics in beach sand and seawater samples from recreational and non-recreational beaches over a two-year period

The frequencies of Escherichia coli, Staphylococcus aureus and Methicillin-resistant S. aureus (MRSA) and 'aerobic mesophilic bacteria' (AMB) counts in different seasons and marine sources were compared to understand the microbiological dynamics at beaches in N. Cyprus. Also, antibiotic resistance patterns were evaluated. The characterization and AMB enumeration studies were performed by conventional microbiological methods. AMB counts increased from winter to summer significantly (45.5*10⁴ CFU/mL to 2.5*10⁶ CFU/mL). Similarly, percentage detection frequencies of the bacteria were higher in summer compared to winter and were significant particularly for E. coli in both sand and seawater samples in 2019 and 2020 (p = 0.0181, p = 0.0142, p = 0.1257, p = 0.0446, respectively). However, a significant difference was not detected in percentage detection frequencies in terms of different sources or recreational status of beaches. The highest resistance percentages were detected against beta-lactam and lincosamides group of antibiotics. Results of the study signified that regular microbiological monitoring for beaches is essential.

Prevalence of MRSA as an Infectious Agent in Sanitary Swimming Pools and Jacuzzis

INTRODUCTION

Methicillin-resistant Staphylococcus aureus (MRSA) is considered resistant to beta-lactam antibiotic groups. Infection caused by this strain is more difficult to treat with antibiotics, and hence, it will be more dangerous. This study focused on detecting the mecA gene Staphylococcus in sanitary swimming pools and Jacuzzis in Yazd city, Iran (2019). Also, the relationship between methicillin-resistant Staphylococcus aureus (MRSA) and the water quality standards has been investigated.

MATERIALS AND METHODS

60 samples were randomly collected in sterile bottles from 20 active pools and Jacuzzis. Quality parameters were analyzed by standard methods. Antibiotic resistance and the mecA gene's presence were detected by the disk diffusion and PCR method, respectively.

RESULTS

The results of this study showed that the resistance of Staphylococcus aureus isolates was high against erythromycin (41.20%), tetracycline (35.10%), clindamycin (28.90%), and cefoxitin (25.80%). Out of 97 samples, 9 (25.80%) strains of Staphylococcus aureus were identified as MRSA, 30 samples (30.92%) showed multiple patterns of antibiotic resistance, and 9 samples (9.27%) carried the mecA gene. The results revealed that water quality has greatly impacted the mecA gene strain presence, especially microbial parameters. On the other hand, in the presence of mecA gene strains, the averages of microbial qualities were higher than standard in Jacuzzis; the latter finding was confirmed for swimming pools due to physicochemical parameters.

CONCLUSION

The number of reported sanitary water is increasing, and this study's results are useful examples of these findings. Therefore, a lack of careful and regular monitoring of swimming pools and Jacuzzis can lead to MSRA prevalence and outbreak sources.

Physicochemical characterization of monazite sand and its associated bacterial species from the beaches of southeastern Brazil

Beaches with monazitic sands show high natural radiation, and the knowledge of this radiation is fundamental to simulate the effects of natural terrestrial radiation on biological systems. Monazite-rich sand from a beach in the southeastern Brazil were collected and analyzed by X-ray fluorescence, X-ray diffraction, and magnetic susceptibility. The natural terrestrial radiation of the beach sand showed a positive correlation with the Th and Y elements, which are closely associated with Ce, Nd, Ca, and P, suggesting that this grouping is mainly associated with local natural radiation. Based on the sand characterization, a physical simulator of natural gamma radiation was built with parameters similar to those of the monazite beach sand, considering areas with high natural radiation levels. The simulation revealed that the natural radiation of the monazite sands has a significant effect on reducing the growth of the bacteria strains of E. coli and S. aureus present in the beach sand, with a reduction of 23.8% and 18.4%, respectively.

Quantitative Microbial Risk Assessment of Antimicrobial Resistant and Susceptible Staphylococcus aureus in Reclaimed Wastewaters

The annual risks of colonization, skin infection, bloodstream infection (BSI), and disease burden from exposures to antibiotic-resistant and susceptible Staphylococcus aureus (S. aureus) were estimated using quantitative microbial risk assessment (QMRA). We estimated the probability of nasal colonization after immersion in wastewater (WW) or greywater (GW) treated across a range of treatment alternatives and subsequent infection. Horizontal gene transfer was incorporated into the treatment model but had little effect on the predicted risk. The cumulative annual probability of infection (resulting from self-inoculation) was most sensitive to the treatment log₁₀ reduction value (LRV), S. aureus concentration, and the newly calculated morbidity ratios and was below the health benchmark of 10^-4 infections per person per year (ppy) given a treatment LRV of roughly 3.0. The predicted annual disability-adjusted life years (DALYs), which were dominated by BSI, were below the health benchmark of 10^-6 DALYs ppy for resistant and susceptible S. aureus, given LRVs of 4.5 and 3.5, respectively. Thus, the estimated infection risks and disease burdens resulting from nasal colonization are below the relevant health benchmarks for risk-based, nonpotable, or potable reuse systems but possibly above for immersion in minimally treated GW or WW. Strain-specific data to characterize dose-response and concentration in WW are needed to substantiate the QMRA.

Environmental Surveillance and Characterization of Antibiotic Resistant Staphylococcus aureus at Coastal Beaches and Rivers on the Island of Hawai'i

Staphylococcus aureus are human facultative pathogenic bacteria and can be found as contaminants in the environment. The aim of our study was to determine whether methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) isolated from coastal beach and river waters, anchialine pools, sand, and wastewater on the island of Hawaiʻi, Hawaiʻi, are a potential health risk. Samples were collected from three regions on Hawaiʻi Island from July to December 2020 during the COVID-19 pandemic and were characterized using whole-genome sequencing (WGS). From WGS data, multilocus sequence typing (MLST), SCCmec type, antimicrobial resistance genes, virulence factors, and plasmids were identified. Of the 361 samples, 98.1% were positive for Staphylococcus spp. and 7.2% were S. aureus positive (n = 26); nine MRSA and 27 MSSA strains were characterized; multiple isolates were chosen from the same sample in two sand and seven coastal beach water samples. The nine MRSA isolates were multi-drug resistant (6–9 genes) sequence type (ST) 8, clonal complex (CC) 8, SCCmec type IVa (USA300 clone), and were clonally related (0–16 SNP differences), and carried 16–19 virulence factors. The 27 MSSA isolates were grouped into eight CCs and 12 STs. Seventy-eight percent of the MSSA isolates carried 1–5 different antibiotic resistance genes and carried 5–19 virulence factors. We found S. aureus in coastal beach and river waters, anchialine pools, and sand at locations with limited human activity on the island of Hawaiʻi. This may be a public health hazard.

Bather Shedding as a Source of Human Fecal Markers to a Recreational Beach

Microbial source tracking (MST) can identify and locate surf zone fecal indicator bacteria (FIB) sources. However, DNA-based fecal marker results may raise new questions, since FIB and DNA marker sources can differ. Here, during 2 years of summertime (dry season) MST for a Goleta, California recreational beach, surf zone FIB were mainly from gulls, yet low level human-associated DNA-based fecal marker (HF183) was detected in 25 and 14% of surf zone water samples, respectively. Watershed sources were hypothesized because dry weather creek waters had elevated FIB, and runoff-generating rain events mobilized human (and dog) fecal markers and Salmonella spp. into creeks, with human marker HF183 detected in 40 and 50% of creek water samples, dog markers detected in 70 and 50% of samples, and Salmonella spp. in 40 and 33.3% of samples, respectively over 2 years. However, the dry weather estuary outlet was bermed in the first study year; simultaneously, creek fecal markers and pathogens were lower or similar to surf zone results. Although the berm breached in the second year, surf zone fecal markers stayed low. Watershed sediments, intertidal beach sands, and nearshore sediments were devoid of HF183 and dog-associated DNA markers. Based on dye tests and groundwater sampling, beach sanitary sewers were not leaking; groundwater was also devoid of HF183. Offshore sources appeared unlikely, since FIB and fecal markers decreased along a spatial gradient from the surf zone toward nearshore and offshore ocean waters. Further, like other regional beaches, surf zone HF183 corresponded significantly to bather counts, especially in the afternoons when there were more swimmers. However, morning detections of surf zone HF183 when there were few swimmers raised the possibility that the wastewater treatment plant (WWTP) offshore outfall discharged HF183 overnight which transported to the surf zone. These findings support that there may be lowest achievable limits of surf zone HF183 owing to several chronic and permanent, perhaps diurnal, low concentration sources.

Staphylococcus aureus-An Additional Parameter of Bathing Water Quality for Crowded Urban Beaches

During the last years, the report of the occurrence of waterborne disease symptoms related to non-enteric pathogens has increased, without any record of higher levels of indicator bacteria (Escherichia coli and intestinal enterococci). Therefore, the use of current indicators is not always adequate when assessing the overall potential health risk and the inclusion of additional parameters needs to be examined. This paper reports on the incidence and levels of Staphylococcus aureus at 258 locations in Primorje-Gorski Kotar County (Croatia) recorded by official bathing water quality monitoring, as well as supplemental monitoring carried out at the two most frequented beaches in the City of Rijeka. The number of bathers was found to be the main factor affecting S. aureus levels (r = 0.321, p < 0.05). The share of S. aureus positive samples from the official monitoring was significantly lower, when compared to the share of samples from supplemental monitoring (2.2% and 36.3%, respectively; p < 0.01). Besides the number of bathers, one of the main reasons is likely the higher sampling frequency. No correlation was found between S. aureus levels and the indicator bacteria. The results indicate that the determination of S. aureus and increased sampling frequency is recommended for overcrowded beaches.

Diversity and genetic lineages of environmental staphylococci: a surface water overview

Antimicrobial resistance in the environmental dimension is one of the greatest challenges and emerging threats. The presence of resistant bacteria and resistance genes in the environment, especially in aquatic systems, has been a matter of growing concern in the past decade. Monitoring the presence of antimicrobial resistance species, in this particular case, Staphylococcus spp., in natural water environments could lead to a better understanding of the epidemiology of staphylococci infections. Thus, the investigation of natural waters as a potential reservoir and vehicle for transmission of these bacteria is imperative. Only a few studies have investigated the prevalence, antimicrobial resistance and genetic lineages of staphylococci in natural waters. Those studies reported a high diversity of staphylococci species and lineages in surface waters. Methicillin-resistant S. aureus were relatively prevalent in surface waters and, as expected, often presented a multidrug-resistant profile. There was a high diversity of S. aureus lineages in surface waters. The presence of S. aureus CC8 and CC5 suggests a human origin. Among the coagulase-negative staphylococci, the most frequently found in natural waters was S. warneri and S. epidermidis. These studies are extremely important to estimate the contribution of the aquatic environment in the spread of pathogenic bacteria.

Streptococcal Infections in Marine Mammals

Marine mammals are sentinels for the marine ecosystem and threatened by numerous factors including infectious diseases. One of the most frequently isolated bacteria are beta-hemolytic streptococci. However, knowledge on ecology and epidemiology of streptococcal species in marine mammals is very limited. This review summarizes published reports on streptococcal species, which have been detected in marine mammals. Furthermore, we discuss streptococcal transmission between and adaptation to their marine mammalian hosts. We conclude that streptococci colonize and/or infect marine mammals very frequently, but in many cases, streptococci isolated from marine mammals have not been further identified. How these bacteria disseminate and adapt to their specific niches can only be speculated due to the lack of respective research. Considering the relevance of pathogenic streptococci for marine mammals as part of the marine ecosystem, it seems that they have been neglected and should receive scientific interest in the future.

Microbial Source Tracking of Fecal Indicating Bacteria in Coral Reef Waters, Recreational Waters, and Groundwater of Saipan by Real-Time Quantitative PCR

The Commonwealth of the Northern Mariana Islands (CNMI) recently identified the need to improve its capacity for detecting and tracking land-based sources of pollution (LBSP) in coastal waters, particularly microbial contaminants like fecal indicator bacteria (FIB). Reported here is a baseline study of a suite of host-specific FIB microbial source tracking (MST) markers in the coastal shoreline and reef waters around the island of Saipan. Three sampling campaigns were conducted in September 2017, March 2018, and August 2018. Samples were collected from the nearshore surface waters of Saipan, the reef waters of Saipan Lagoon, and groundwater from beaches along the Saipan Lagoon shoreline. Measurements of submarine groundwater discharge (SGD) into nearshore waters and isotopic source tracking of nitrogen inputs were conducted concurrently with MST. Environmental DNA was extracted from the samples and analyzed by quantitative polymerase chain reaction (qPCR) for MST gene markers of fecal Bacteroidales specifically associated with humans, dogs, cows, and pigs, and for an MST gene marker of Catellicoccus associated with seabirds. MST assessments were combined with local knowledge, assessments of sanitary infrastructure, and routine watershed surveys. This study identified hotspots of human FIB along the western Saipan Lagoon shoreline in both surface waters and groundwater, plus another hotspot of human FIB at a popular tourist bathing area known as the Grotto. FIB hotspots on the Lagoon shoreline coincided with areas of high SGD and nitrogen isotopic data indicating sewage-derived N inputs. It appears that faulty sanitary infrastructure may be contributing to inputs to Saipan Lagoon, while bather shedding is likely a primary input for the Grotto area. Moderate levels of dog fecal contamination were common and widespread across the island. High levels of seabird fecal contamination were more random, both spatially and temporally, and mostly concentrated along the less developed northeast region of Saipan. No significant levels of cow or pig fecal marker were detected in coastal water samples. This study provides demonstration and establishment of analytical capacity to resource management in CNMI for MST technology to aid in trouble-shooting water quality issues involving land-based sources of microbial contaminants to CNMI coastal waters.

Impacts of a changing earth on microbial dynamics and human health risks in the continuum between beach water and sand

Although infectious disease risk from recreational exposure to waterborne pathogens has been an active area of research for decades, beach sand is a relatively unexplored habitat for the persistence of pathogens and fecal indicator bacteria (FIB). Beach sand, biofilms, and water all present unique advantages and challenges to pathogen introduction, growth, and persistence. These dynamics are further complicated by continuous exchange between sand and water habitats. Models of FIB and pathogen fate and transport at beaches can help predict the risk of infectious disease from beach use, but knowledge gaps with respect to decay and growth rates of pathogens in beach habitats impede robust modeling. Climatic variability adds further complexity to predictive modeling because extreme weather events, warming water, and sea level change may increase human exposure to waterborne pathogens and alter relationships between FIB and pathogens. In addition, population growth and urbanization will exacerbate contamination events and increase the potential for human exposure. The cumulative effects of anthropogenic changes will alter microbial population dynamics in beach habitats and the assumptions and relationships used in quantitative microbial risk assessment (QMRA) and process-based models. Here, we review our current understanding of microbial populations and transport dynamics across the sand-water continuum at beaches, how these dynamics can be modeled, and how global change factors (e.g., climate and land use) should be integrated into more accurate beachscape-based models.

Prevalence and Characterization of Staphylococcus aureus and Methicillin-Resistant Staphylococcus aureus on Public Recreational Beaches in Northeast Ohio

Staphylococcus aureus can cause severe life-threatening illnesses such as sepsis and endocarditis. Although S. aureus has been isolated from marine water and intertidal beach sand, only a few studies have been conducted to assess prevalence of S. aureus at freshwater recreational beaches. As such, we aimed to determine prevalence and molecular characteristics of S. aureus in water and sand at 10 freshwater recreational beaches in Northeast Ohio, USA. Samples were analyzed using standard microbiology methods, and resulting isolates were typed by spa typing and multilocus sequence typing. The overall prevalence of S. aureus in sand and water samples was 22.8% (64/280). The prevalence of methicillin-resistant S. aureus (MRSA) was 8.2% (23/280). The highest prevalence was observed in summer (45.8%; 55/120) compared to fall (4.2%; 5/120) and spring (10.0%; 4/40). The overall prevalence of Panton-Valentine leukocidin genes among S. aureus isolates was 21.4% (15/70), and 27 different spa types were identified. The results of this study indicate that beach sand and freshwater of Northeast Ohio were contaminated with S. aureus, including MRSA. The high prevalence of S. aureus in summer months and presence of human-associated strains may indicate the possibility of role of human activity in S. aureus contamination of beach water and sand. While there are several possible routes for S. aureus contamination, S. aureus prevalence was higher in sites with wastewater treatment plants proximal to the beaches.

Antimicrobial Susceptibility of Staphylococcus aureus Isolated from Recreational Waters and Beach Sand in Eastern Cape Province of South Africa

Background: Resistance of Staphylococcus aureus to commonly used antibiotics is linked to their ability to acquire and disseminate antimicrobial-resistant determinants in nature, and the marine environment may serve as a reservoir for antibiotic-resistant bacteria. This study determined the antibiotic sensitivity profile of S.aureus isolated from selected beach water and intertidal beach sand in the Eastern Cape Province of South Africa. Methods: Two hundred and forty-nine beach sand and water samples were obtained from 10 beaches from April 2015 to April 2016. Staphylococcus aureus was isolated from the samples using standard microbiological methods and subjected to susceptibility testing to 15 antibiotics. Methicillin-resistant Staphylococcus aureus (MRSA) was detected by susceptibility to oxacillin and growth on Brilliance MRSA II agar. Antibiotic resistance genes including mecA, femA rpoB, blaZ, ermB, ermA, ermC, vanA, vanB, tetK and tetM were screened. Results: Thirty isolates (12.3%) were positive for S. aureus by PCR with over 50% showing phenotypic resistance to methicillin. Resistance of S. aureus to antibiotics varied considerably with the highest resistance recorded to ampicillin and penicillin (96.7%), rifampicin and clindamycin (80%), oxacillin (73.3%) and erythromycin (70%). S.aureus revealed varying susceptibility to imipenem (96.7%), levofloxacin (86.7%), chloramphenicol (83.3%), cefoxitin (76.7%), ciprofloxacin (66.7%), gentamycin (63.3%), tetracycline and sulfamethoxazole-trimethoprim (56.7%), and vancomycin and doxycycline (50%). All 30 (100%) S. aureus isolates showed multiple antibiotic-resistant patterns (resistant to three or more antibiotics). The mecA, femA, rpoB, blaZ, ermB and tetM genes were detected in 5 (22.7%), 16 (53.3%), 11 (45.8%), 16 (55.2%), 15 (71.4%), and 8 (72.7%) isolates respectively; Conclusions: Results from this study indicate that beach water and sand from the Eastern Cape Province of South Africa may be potential reservoirs of antibiotic-resistant S. aureus which could be transmitted to exposed humans and animals.

Toward a better guard of coastal water safety-Microbial distribution in coastal water and their facile detection

Prosperous development in marine-based tourism has raised increasing concerns over the sanitary quality of coastal waters with potential microbial contamination. The World Health Organization has set stringent standards over a list of pathogenic microorganisms posing potential threats to people with frequent coastal water exposure and has asked for efficient detection procedures for pathogen facile identification. Inspection of survey events regarding the occurrence of marine pathogens in recreational beaches in recent years has reinforced the need for the development of a rapid identification procedure. In this review, we examine the possibility of recruiting uniform molecular assays to identify different marine pathogens and the feasibility of appropriate biomarkers, including enterochelin biosynthetic genes, for general toxicity assays. The focus is not only on bacterial pathogens but also on other groups of infectious pathogens. The ultimate goal is the development of a handy method to more efficiently and rapidly detect marine pathogens.

Sediment characteristics and microbiological contamination of beach sand - A case-study in the archipelago of Madeira

Beach sand can harbour pathogenic and opportunistic microorganisms, as well as faecal indicator bacteria that influence directly the bathing water quality. Pathogenic and opportunistic microorganisms often raise concern of exposure during beach related recreational activities. In this work, three different types of sandy beaches (natural basaltic, natural calcareous and artificial calcareous) of the Archipelago of Madeira (Portugal) were sampled for bacterial and fungal contaminants and grain size distribution, during four years (2010-2013). Following an extreme weather event in 2010, the faecal indicator bacteria levels spiked, returning to base levels shortly thereafter. The same phenomenon occurred with fungi, where potentially pathogenic fungi were the dominant group. Yeast-like fungi and dermatophytes were, however, mainly associated to months of higher usage by recreational users. Statistical analysis showed higher contamination of sediment in artificial beaches compared to natural beaches and granulometry and chemical composition of sand did not influence in the microbial loads. Instead, bather density and the influence of coastal protection structures needed to maintain the volume of artificial beach sand regarding the removal potential of wave induced currents are obvious influencing factors.

Occurrence of methicillin-resistant Staphylococcus aureus in surface waters near industrial hog operation spray fields

Industrial hog operations (IHOs) have been identified as a source of antibiotic-resistant Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA). However, few studies have investigated the presence of antibiotic-resistant S. aureus in the environment near IHOs, specifically surface waters proximal to spray fields where IHO liquid lagoon waste is sprayed. Surface water samples (n=179) were collected over the course of approximately one year from nine locations in southeastern North Carolina and analyzed for the presence of presumptive MRSA using CHROMagar MRSA media. Culture-based, biochemical, and molecular tests, as well as matrix-assisted laser desorption/ionization-time of flight mass spectrometry were used to confirm that isolates that grew on CHROMagar MRSA media were S. aureus. Confirmed S. aureus isolates were then tested for susceptibility to 16 antibiotics and screened for molecular markers of MRSA (mecA, mecC) and livestock adaptation (absence of scn). A total of 12 confirmed MRSA were detected in 9 distinct water samples. Nine of 12 MRSA isolates were also multidrug-resistant (MDRSA [i.e., resistant to ≥3 antibiotic classes]). All MRSA were scn-positive and most (11/12) belonged to a staphylococcal protein A (spa) type t008, which is commonly associated with humans. Additionally, 12 confirmed S. aureus that were methicillin-susceptible (MSSA) were recovered, 7 of which belonged to spa type t021 and were scn-negative (a marker of livestock-adaptation). This study demonstrated the presence of MSSA, MRSA, and MDRSA in surface waters adjacent to IHO lagoon waste spray fields in southeastern North Carolina. To our knowledge, this is the first report of waterborne S. aureus from surface waters proximal to IHOs.

Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) at ambient freshwater beaches

Methicillin-resistant Staphylococcus aureus (MRSA) are a threat to human health worldwide, and although detected at marine beaches, they have been largely unstudied at freshwater beaches. Genes indicating S. aureus (SA; femA) and methicillin resistance (mecA) were detected at 11 and 12 of 13 US Great Lakes beaches and in 18% or 27% of 287 recreational water samples, respectively. Eight beaches had mecA+femA (potential MRSA) detections. During an intensive study, higher bather numbers, staphylococci concentrations, and femA detections were found in samples collected after noon than before noon. Local population density, beach cloud cover, and beach wave height were significantly correlated with SA or MRSA detection frequency. The Panton-Valentine leukocidin gene, associated with community-acquired MRSA, was detected in 12 out of 27 potential MRSA samples. The femA gene was detected less frequently at beaches that met US enterococci criteria or EU enterococci 'excellent' recreational water quality, but was not related to Escherichia coli-defined criteria. Escherichia coli is often the only indicator used to determine water quality at US beaches, given the economic and healthcare burden that can be associated with infections caused by SA and MRSA, monitoring of recreational waters for non-fecal bacteria such as staphylococci and/or SA may be warranted.

Detection of mecC-Methicillin-resistant Staphylococcus aureus isolates in river water: a potential role for water in the environmental dissemination

Methicillin-resistant Staphylococcus aureus (MRSA) is a public health concern due to limited treatment options. The recent description of a mecA homologue, mecC in human and cattle, led to studies to detect this new variant in human and other animal species. Detection of mecC in wild boar and fallow deer in a Spanish game estate led us to further investigate the presence of mecC-MRSA at this location. Samples from cattle, wild animals, workers and river water were tested. A further three mecC-MRSA isolates were obtained from river water. Molecular characterization (multilocus sequence typing and spa typing) and antimicrobial susceptibility testing (broth microdilution) showed that isolates were similar to those detected in wild animals. Whole genome sequencing confirmed that the isolates from the river water and wild animals in the same geographic area were all closely related isolates of ST425 mecC-MRSA. The presence of mecC-MRSA in the river water highlights the potential role of water in the dissemination of mecC-MRSA.

Microbes in Beach Sands: Integrating Environment, Ecology and Public Health

Beach sand is a habitat that supports many microbes, including viruses, bacteria, fungi and protozoa (micropsammon). The apparently inhospitable conditions of beach sand environments belie the thriving communities found there. Physical factors, such as water availability and protection from insolation; biological factors, such as competition, predation, and biofilm formation; and nutrient availability all contribute to the characteristics of the micropsammon. Sand microbial communities include autochthonous species/phylotypes indigenous to the environment. Allochthonous microbes, including fecal indicator bacteria (FIB) and waterborne pathogens, are deposited via waves, runoff, air, or animals. The fate of these microbes ranges from death, to transient persistence and/or replication, to establishment of thriving populations (naturalization) and integration in the autochthonous community. Transport of the micropsammon within the habitat occurs both horizontally across the beach, and vertically from the sand surface and ground water table, as well as at various scales including interstitial flow within sand pores, sediment transport for particle-associated microbes, and the large-scale processes of wave action and terrestrial runoff. The concept of beach sand as a microbial habitat and reservoir of FIB and pathogens has begun to influence our thinking about human health effects associated with sand exposure and recreational water use. A variety of pathogens have been reported from beach sands, and recent epidemiology studies have found some evidence of health risks associated with sand exposure. Persistent or replicating populations of FIB and enteric pathogens have consequences for watershed/beach management strategies and regulatory standards for safe beaches. This review summarizes our understanding of the community structure, ecology, fate, transport, and public health implications of microbes in beach sand. It concludes with recommendations for future work in this vastly under-studied area.

Human mitochondrial DNA and endogenous bacterial surrogates for risk assessment of graywater reuse

Previous graywater risk assessment studies have focused on fecal contamination, yet the low density of fecal indicators may not provide the most useful approach to assess pathogen removal during graywater treatment. In this study, we employed high throughput bacterial sequencing and qPCR to elucidate potential microbial surrogates in wastewater sourced from an industrial laundry. In addition, we explored human mitochondrial DNA (HmtDNA) as a new, potentially more reliable molecular marker, because it can be unambiguously sourced, has a high copy number per cell, and is persistent when released from cells with no self-replication in graywater. Pyrosequencing and qPCR revealed that laundry water microbiota was dominated by the skin-associated bacteria Staphylococcus, Corynebacterium, and Propionibacterium (6.5, 5.7, 5.4 log10 copies/100 mL, respectively). While HmtDNA was less abundant (2.8 log10 copies/100 mL), it showed a strong positive correlation with the opportunistic pathogen Staphylococcus aureus (r=0.54, P=3.2×10(-4)) and closely followed a first-order exponential decay model (R2=0.98), remaining detectable in stored laundry graywater for up to 6 days at 20 °C. Based on abundance and persistence, we propose HmtDNA and total Staphylococcus as future laundry graywater treatment surrogates to potentially assess a wide dynamic range of pathogen removal.

Water quality assessment of an unusual ritual well in Bangladesh and impact of mass bathing on this quality

A sacred ritual well with continuously discharging of methane gas through its water body was studied for physicochemical and microbiological quality in three seasons and during ritual mass bathing. Most of the physicochemical parameters showed significant seasonal variations (P<0.05) and a sharp fluctuation during mass bathing. Dissolved oxygen (DO) was found negatively correlated with temperature (r=-0.384, P<0.05), biochemical oxygen demand (BOD) (r=-0.58, P<0.001) and ammonia (r=-0.738, P<0.001), while BOD showed positive correlation with chemical oxygen demand (COD) (r=0.762, P<0.001) and ammonia (r=0.83, P<0.001). Simple regression analysis also yielded significant linear relationship in DO vs. temperature (r(2)=0.147, P<0.05), DO vs. ammonia (r(2)=0.544, P<0.001) and BOD vs. DO (r(2)=0.336, P<0.001). A total of eight microbial indicators were studied and found that all of them increased unusually during mass bathing comparing with their respective seasonal values. Total coliforms (TC) were found positively correlated with fecal coliforms (FC) (r=0.971), FC with Escherichia coli (EC) (r=0.952), EC with intestinal enterococci (IE) (r=0.921), fecal streptococci (FS) with IE (r=0.953) and Staphylococcus aureus (SA) with Pseudomonas aeruginosa (PA) (r=0.946), which were significant at P<0.001. Some regression models showed significant linear relationship at P<0.001 with r(2) value of 0.943 for FC vs. TC, 0.907 for EC vs. FC, 0.869 for FS vs. FC, 0.848 for IE vs. EC and 0.909 for IE vs. FS. The overall results found in this study revealed that well water is suitable for bathing purpose but the religious activity considerably worsen its quality.

Knowledge and perceptions about community-acquired staphylococcal infections among health care workers in Hawai'i

Since the early 1990s, national rates of methicillin-resistant Staphylococcus aureus (MRSA) infections have increased dramatically.1,2 Initially identified in health care settings, community-acquired MRSA is now a major public health concern. With Hawai'i's expanding S. aureus and MRSA epidemic closely approximating the national trend in inpatient and outpatient settings,7,8 a high level of knowledge and awareness among health care workers is essential to successfully control this evolving epidemic. Health care and related workers were surveyed to assess their knowledge and perceptions about staphylococcal and MRSA infections. Knowledge was estimated by demonstrated ability to correctly identify risk factors including diabetes and obesity, as well as to demonstrate awareness of a growing staphylococcal and MRSA epidemic.9,10 Perceptions were estimated by level of concern of antibiotic resistance as well as of the severity of the staphylococcal and MRSA epidemic. Variations in knowledge and perception concerning basic principles associated with S. aureus infections as well as characteristics of the evolving S. aureus and MRSA epidemic were observed among various occupations (advance clinical practitioners, nurses, public health professionals, athletic trainers, and non-medical workers) as well as work locations (hospital, community, and non-clinical community). Overall, health care and related workers in community settings demonstrated disparities in knowledge regarding S. aureus and MRSA infections. They were also more likely to misperceive this growing threat. These findings provide support for focused educational interventions targeting community health care and related workers to improve awareness of staphylococcal infections in order to successfully address and combat this evolving epidemic.

Identification of Staphylococcus aureus from enriched nasal swabs within 24 h is improved with use of multiple culture media

Nasal carriage of Staphylococcus aureus is commonly evaluated via culture-based methods. We found that parallel use of two media, Baird-Parker and CHROMagar™ Staph aureus, increased detection of S. aureus from a healthy population by 29 %. We suggest use of both media for optimal identification of S. aureus from healthy cohorts.

Human-associated methicillin-resistant Staphylococcus aureus from a subtropical recreational marine beach

Reports of Staphylococcus aureus including methicillin-resistant S. aureus (MRSA) detected in marine environments have occurred since the early 1990 s. This investigation sought to isolate and characterize S. aureus from marine waters and sand at a subtropical recreational beach, with and without bathers present, in order to investigate possible sources and to identify the risks to bathers of exposure to these organisms. During 40 days over 17 months, 1,001 water and 36 intertidal sand samples were collected by either bathers or investigators at a subtropical recreational beach. Methicillin-sensitive S. aureus (MSSA) and MRSA were isolated and identified using selective growth media and an organism-specific molecular marker. Antimicrobial susceptibility, staphylococcal cassette chromosome mec (SCCmec) type, pulsed-field gel electrophoresis (PFGE) pattern, multi-locus sequence type (MLST), and staphylococcal protein A (spa) type were characterized for all MRSA. S. aureus was isolated from 248 (37 %) bather nearby water samples at a concentration range of <2-780 colony forming units per ml, 102 (31 %) ambient water samples at a concentration range of <2-260 colony forming units per ml, and 9 (25 %) sand samples. Within the sand environment, S. aureus was isolated more often from above the intertidal zone than from intermittently wet or inundated sand. A total of 1334 MSSA were isolated from 37 sampling days and 22 MRSA were isolated from ten sampling days. Seventeen of the 22 MRSA were identified by PFGE as the community-associated MRSA USA300. MRSA isolates were all SCCmec type IVa, encompassed five spa types (t008, t064, t622, t688, and t723), two MLST types (ST8 and ST5), and 21 of 22 isolates carried the genes for Panton-Valentine leukocidin. There was a correlation (r = 0.45; p = 0.05) between the daily average number of bathers and S. aureus in the water; however, no association between exposure to S. aureus in these waters and reported illness was found. This report supports the concept that humans are a potential direct source for S. aureus in marine waters.

Clonally related methicillin-resistant Staphylococcus aureus isolated from short-finned pilot whales (Globicephala macrorhynchus), human volunteers, and a bayfront cetacean rehabilitation facility

In May of 2011, a live mass stranding of 26 short-finned pilot whales (Globicephala macrorhynchus) occurred in the lower Florida Keys. Five surviving whales were transferred from the original stranding site to a nearby marine mammal rehabilitation facility where they were constantly attended to by a team of volunteers. Bacteria cultured during the routine clinical care of the whales and necropsy of a deceased whale included methicillin-sensitive and methicillin-resistant Staphylococcus aureus (MSSA and MRSA). In order to investigate potential sources or reservoirs of MSSA and MRSA, samples were obtained from human volunteers, whales, seawater, and sand from multiple sites at the facility, nearby recreational beaches, and a canal. Samples were collected on 3 days. The second collection day was 2 weeks after the first, and the third collection day was 2 months after the last animal was removed from the facility. MRSA and MSSA were isolated on each day from the facility when animals and volunteers were present. MSSA was found at an adjacent beach on all three collection days. Isolates were characterized by utilizing a combination of quantitative real-time PCR to determine the presence of mecA and genes associated with virulence, staphylococcal protein A typing, staphylococcal cassette chromosome mec typing, multilocus sequence typing, and pulsed field gel electrophoresis (PFGE). Using these methods, clonally related MRSA were isolated from multiple environmental locations as well as from humans and animals. Non-identical but genetically similar MSSA and MRSA were also identified from distinct sources within this sample pool. PFGE indicated that the majority of MRSA isolates were clonally related to the prototype human strain USA300. These studies support the notion that S. aureus may be shed into an environment by humans or pilot whales and subsequently colonize or infect exposed new hosts.

Comparison of Multi-Drug Resistant Environmental Methicillin-Resistant Staphylococcus aureus Isolated from Recreational Beaches and High Touch Surfaces in Built Environments

Over the last decade community-acquired methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a major cause of disease in the general population with no health care exposure or known classical risk factors for MRSA infections. The potential community reservoirs have not been well defined though certain strains such as ST398 and USA300 have been well studied in some settings. MRSA has been isolated from recreational beaches, high-touch surfaces in homes, universities, and other community environmental surfaces. However, in most cases the strains were not characterized to determine if they are related to community-acquired or hospital-acquired clinical strains. We compared 55 environmental MRSA from 805 samples including sand, fresh, and marine water samples from local marine and fresh water recreational beaches (n = 296), high touch surfaces on the University of Washington campus (n = 294), surfaces in UW undergraduate housing (n = 85), and the local community (n = 130). Eleven USA300, representing 20% of the isolates, were found on the UW campus surfaces, student housing surfaces, and on the community surfaces but not in the recreational beach samples from the Northwest USA. Similarly, the predominant animal ST133 was found in the recreational beach samples but not in the high touch surface samples. All USA300 isolates were multi-drug resistant carrying two to six different antibiotic resistance genes coding for kanamycin, macrolides and/or macrolides-lincosamides-streptogramin B, and tetracycline, with the majority (72%) carrying four to six different antibiotic resistance genes. A surprising 98% of the 55 MRSA isolates were resistant to other classes of antibiotics and most likely represent reservoirs for these genes in the environment.

Methicillin-resistant Staphylococcus aureus foot infection after fish pedicure

Fish pedicure has become a popular cosmetic procedure involving immersion of the feet in a tank with freshwater fish (Garra rufa) that nibble off dead skin. There are concerns about the potential transmission of pathogens, but no cases of infections after this procedure have been published so far. We present a patient who developed foot infection with methicillin-resistant Staphylococcus aureus (MRSA) after fish pedicure.

An alternative approach to water regulations for public health protection at bathing beaches

New approaches should be considered as the US Environmental Protection Agency (EPA) moves rapidly to develop new beach monitoring guidelines by the end of 2012, as these guidelines serve as the basis by which states and territories with coasts along the oceans and Great Lakes can then develop and implement monitoring programs for recreational waters. We describe and illustrate one possible approach to beach regulation termed as the “Comprehensive Toolbox within an Approval Process (CTBAP).” The CTBAP consists of three components. The first is a “toolbox” consisting of an inventory of guidelines on monitoring targets, a series of measurement techniques, and guidance to improve water quality through source identification and prevention methods. The second two components are principles of implementation. These include first, “flexibility” to encourage and develop an individualized beach management plan tailored to local conditions and second, “consistency” of this management plan to ensure a consistent national level of public health protection. The results of this approach are illustrated through a case study at a well-studied South Florida recreational marine beach. This case study explores different monitoring targets based on two different health endpoints (skin versus gastrointestinal illness) and recommends a beach regulation program for the study beach that focuses predominately on source prevention.

Geographic setting influences Great Lakes beach microbiological water quality

Understanding of factors that influence Escherichia coli (EC) and enterococci (ENT) concentrations, pathogen occurrence, and microbial sources at Great Lakes beaches comes largely from individual beach studies. Using 12 representative beaches, we tested enrichment cultures from 273 beach water and 22 tributary samples for EC, ENT, and genes indicating the bacterial pathogens Shiga-toxin producing E. coli (STEC), Shigella spp. , Salmonella spp , Campylobacter jejuni/coli , and methicillin-resistant Staphylococcus aureus , and 108-145 samples for Bacteroides human, ruminant, and gull source-marker genes. EC/ENT temporal patterns, general Bacteroides concentration, and pathogen types and occurrence were regionally consistent (up to 40 km), but beach catchment variables (drains/creeks, impervious surface, urban land cover) influenced exceedances of EC/ENT standards and detections of Salmonella and STEC. Pathogen detections were more numerous when the EC/ENT Beach Action Value (but not when the Geometric Mean and Statistical Threshold Value) was exceeded. EC, ENT, and pathogens were not necessarily influenced by the same variables. Multiple Bacteroides sources, varying by date, occurred at every beach. Study of multiple beaches in different geographic settings provided new insights on the contrasting influences of regional and local variables, and a broader-scale perspective, on significance of EC/ENT exceedances, bacterial sources, and pathogen occurrence.

Methicillin-resistant Staphylococcus aureus (MRSA) detected at four U.S. wastewater treatment plants

BACKGROUND

The incidence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections is increasing in the United States, and it is possible that municipal wastewater could be a reservoir of this microorganism. To date, no U.S. studies have evaluated the occurrence of MRSA in wastewater.

OBJECTIVE

We examined the occurrence of MRSA and methicillin-susceptible S. aureus (MSSA) at U.S. wastewater treatment plants.

METHODS

We collected wastewater samples from two Mid-Atlantic and two Midwest wastewater treatment plants between October 2009 and October 2010. Samples were analyzed for MRSA and MSSA using membrane filtration. Isolates were confirmed using biochemical tests and PCR (polymerase chain reaction). Antimicrobial susceptibility testing was performed by Sensititre® microbroth dilution. Staphylococcal cassette chromosome mec (SCCmec) typing, Panton-Valentine leucocidin (PVL) screening, and pulsed field gel electrophoresis (PFGE) were performed to further characterize the strains. Data were analyzed by two-sample proportion tests and analysis of variance.

RESULTS

We detected MRSA (n = 240) and MSSA (n = 119) in 22 of 44 (50%) and 24 of 44 (55%) wastewater samples, respectively. The odds of samples being MRSA-positive decreased as treatment progressed: 10 of 12 (83%) influent samples were MRSA-positive, while only one of 12 (8%) effluent samples was MRSA-positive. Ninety-three percent and 29% of unique MRSA and MSSA isolates, respectively, were multidrug resistant. SCCmec types II and IV, the pvl gene, and USA types 100, 300, and 700 (PFGE strain types commonly found in the United States) were identified among the MRSA isolates.

CONCLUSIONS

Our findings raise potential public health concerns for wastewater treatment plant workers and individuals exposed to reclaimed wastewater. Because of increasing use of reclaimed wastewater, further study is needed to evaluate the risk of exposure to antibiotic-resistant bacteria in treated wastewater.

Comparative studies on Enterococcus, Clostridium perfringens and Staphylococcus aureus as quality indicators in tropical seawater at a Pacific Mexican beach resort

Three microorganisms were assayed to evaluate the microbiological quality in the seawater at a resort on the Mexican Pacific coast, and to test for possible associations among the titers of the various bacteria, their possible correlations with environmental conditions, and with the location of potential wastewater outflows. Significant microorganism levels were found (at Caletilla beach, Hornos beach, and Papagayo beach, respectively: for Enterococcus 157, 153, and 149, for C. perfringens 35, 89, and 56, for S. aureus 244,137, and 279CFU/100ml), often in excess of the presently set guideline values. In general, bacterial titers were higher during rainy season than in dry season. For S. aureus, in both seasons, highest concentrations were found at 3pm, the time of highest tourist presence at the beaches. Our results argue for the use of these three microorganisms as part of a set of indicators in the routine microbiological evaluation of Mexican beachwaters.

High numbers of Staphylococcus aureus at three bathing beaches in South Florida

While the value of Staphylococcus aureus as an indicator for non-enteric diseases is unclear, understanding its prevalence in recreational beaches would prove useful, given its pathogenic potential. Staphylococcus aureus levels were evaluated in sand and seawater at three beaches during one year. To elucidate possible S. aureus sources or colonization trends, distribution in sand was analyzed at Hollywood Beach. Staphylococcus aureus levels fluctuated throughout the study with highest average densities detected in dry sand (3.46 × 10⁵ CFU/g, Hobie Beach), particularly at beaches with high human density. Patchy distribution marked hotspots of human use and/or possible bacterial re-growth. Data from a brief epidemiological survey indicated a very slight association between beach usage and skin conditions; suggesting high S. aureus levels in sand may not necessarily constitute major health risks. Because the possibility of disease transmission exists, particularly to children and immuno-compromised beach-goers, periodic surveying of highly frequented beaches seems warranted.

Survival trends of Staphylococcus aureus, Pseudomonas aeruginosa, and Clostridium perfringens in a sandy South Florida beach

The search for alternative indicators of disease-risk from non-enteric pathogens at the beach revealed high densities of targeted bacteria. To explain the high numbers of potential non-enteric pathogens, Staphylococcus aureus and Pseudomonas aeruginosa, in beach sand, we investigated factors affecting their survival and distribution, as well as those of a potential fecal indicator, Clostridium perfringens. Results indicated greater S. aureus and P. aeruginosa survival and proliferation in sterile beach sand, than seawater, with diminished numbers upon exposure to natural micro-predators. C. perfringens remained relatively consistent with initial numbers. Intermediate sand particles (850 μm-2 mm) constituted the major micro-niche; creating implications for beach classification programs. Colonization of sterile sand boxes at the beach by S. aureus and P. aeruginosa confirmed the filtering action (>100×) of beach sand. The use of these potential pathogens in periodic sanitary evaluation of beach sand quality is indicated, regardless of the factors influencing their abundance.

Spatial and temporal variation in indicator microbe sampling is influential in beach management decisions

Fecal indicator microbes, such as enterococci, are often used to assess potential health risks caused by pathogens at recreational beaches. Microbe levels often vary based on collection time and sampling location. The primary goal of this study was to assess how spatial and temporal variations in sample collection, which are driven by environmental parameters, impact enterococci measurements and beach management decisions. A secondary goal was to assess whether enterococci levels can be predictive of the presence of Staphylococcus aureus, a skin pathogen. Over a ten-day period, hydrometeorologic data, hydrodynamic data, bather densities, enterococci levels, and S. aureus levels including methicillin-resistant S. aureus (MRSA) were measured in both water and sand. Samples were collected hourly for both water and sediment at knee-depth, and every 6 h for water at waist-depth, supratidal sand, intertidal sand, and waterline sand. Results showed that solar radiation, tides, and rainfall events were major environmental factors that impacted enterococci levels. S. aureus levels were associated with bathing load, but did not correlate with enterococci levels or any other measured parameters. The results imply that frequencies of advisories depend heavily upon sample collection policies due to spatial and temporal variation of enterococci levels in response to environmental parameters. Thus, sampling at different times of the day and at different depths can significantly impact beach management decisions. Additionally, the lack of correlation between S. aureus and enterococci suggests that use of fecal indicators may not accurately assess risk for some pathogens.

Quantitative microbial risk assessment of human illness from exposure to marine beach sand

Currently no U.S. federal guideline is available for assessing risk of illness from sand at recreational sites. The objectives of this study were to compute a reference level guideline for pathogens in beach sand and to compare these reference levels with measurements from a beach impacted by nonpoint sources of contamination. Reference levels were computed using quantitative microbial risk assessment (QMRA) coupled with Monte Carlo simulations. In order to reach an equivalent level of risk of illness as set by the U.S. EPA for marine water exposure (1.9 × 10(-2)), levels would need to be at least about 10 oocysts/g (about 1 oocyst/g for a pica child) for Cryptosporidium, about 5 MPN/g (about 1 MPN/g for pica) for enterovirus, and less than 10(6) CFU/g for S. aureus. Pathogen levels measured in sand at a nonpoint source recreational beach were lower than the reference levels. More research is needed in evaluating risk from yeast and helminth exposures as well as in identifying acceptable levels of risk for skin infections associated with sand exposures.

Occurrence and persistence of bacterial pathogens and indicator organisms in beach sand along the California coast

This report documents the presence of fecal indicators and bacterial pathogens in sand at 53 California marine beaches using both culture-dependent and -independent (PCR and quantitative PCR [QPCR]) methods. Fecal indicator bacteria were widespread in California beach sand, with Escherichia coli and enterococci detected at 68% and 94% of the beaches surveyed, respectively. Somatic coliphages and a Bacteroidales human-specific fecal marker were detected at 43% and 13% of the beaches, respectively. Dry sand samples from almost 30% of the beaches contained at least one of the following pathogens: Salmonella spp., Campylobacter spp., Staphylococcus aureus, and methicillin-resistant Staphylococcus aureus (MRSA), which were detected at 15%, 13%, 14%, and 3% of tested beaches, respectively. Fecal indicators and pathogens were poorly correlated to one another and to land cover. Sands were dry at the time of collection, and those with relatively high moisture tended to have higher concentrations or a more frequent occurrence of both indicators and pathogens. Using culture-dependent assays, fecal indicators decayed faster than pathogens in microcosm experiments using unaltered beach sand seeded with sewage and assessed by culture-dependent assays. The following order of persistence was observed (listed from most to least persistent): Campylobacter > Salmonella > somatic coliphages > enterococci > E. coli > F(+) phages. In contrast, pathogens decayed faster than fecal indicators in culture-independent assays: enterococci > Bacteroidales human-specific marker > Salmonella > Campylobacter. Microcosm experiments demonstrated that both indicators and pathogens were mobilized by wetting with seawater. Decay rates measured by QPCR were lower than those measured with culture-dependent methods. Enterococcal persistence and possible growth were observed for wetted microcosms relative to unwetted controls.

Methicillin-resistant Staphylococcus aureus from Northwest marine and freshwater recreational beaches

The aim of the study was to determine the spatial distribution of methicillin-resistant Staphylococcus aureus (MRSA) at two marine and one freshwater recreational beaches in the Seattle area. Fifty-six marine water, 144 freshwater, and 96 sand samples were collected from June through August 2010. Isolates were biochemically verified as MRSA. Staphylococcal cassette chromosome mec (SCCmec) typing, multilocus sequence typing (MLST), pulse field gel electrophoresis and the presence of other antibiotic resistance genes were determined. Twenty-two freshwater (15.3%; n = 144), one dry sand (1.9%; n = 53), six wet sand (14%; n = 43), and two marine water samples (3.6%; n = 56) were MRSA positive. Of the 27 freshwater stream sites sampled multiple times, 37% of the sites were positive for MRSA and/or S. aureus ≥ 2 times. Twenty-one (67.7%) of 31 MRSA were SCCmec type IV, 15 (48.4%) of the isolates had MLST types not previously associated with humans, and 29 (93.5%) of the isolates carried other antibiotic resistance genes. This study is the first to report and characterize repeated MRSA-positive samples from freshwater drainages and creeks surrounding popular recreational beaches.

Survival of environmental and clinical strains of methicillin-resistant Staphylococcus aureus [MRSA] in marine and fresh waters

Recent studies have found variable levels of methicillin-resistant Staphylococcus aureus [MRSA] in marine water from temperate and warmer climates suggesting that temperature may play a role in survival of MRSA in the environment. The aim of the study was to compare the survival of clinical and environmental MRSA and MSSA strains in fresh and marine water incubated at 13 °C and 20 °C over 14 days. Seven different MRSA strains and the MSSA ATCC 25923 were tested. Individual strains were diluted in sterile saline to a 0.5 McFarland standard (10(8) cfu/ml), serially diluted in duplicate to a final concentration of 10(5) cfu/ml in pooled filter-sterilized marine or fresh water and incubated at 13 °C or 20 °C in the dark. The results of this study found that temperature and salinity are important factors in MRSA and MSSA survival; the decay rate was ∼28% higher at 20 °C versus 13 °C and ∼34-44% higher in fresh water versus marine water. There was no statistical difference between environmental and clinical MRSA strain survival [P = 0.138]. The study found that MRSA/MSSA survival was significantly longer in marine water at 13 °C typical of the Pacific Northwest, which may have important implications for recreational beach visitors in colder climates.

Impact of erosion and accretion on the distribution of enterococci in beach sands

Bacterial pathogens in coastal sediments may pose a health risk to users of beaches. Although recent work shows that beach sands harbor both indicator bacteria and potential pathogens, it is not known how deep within beach sands the organisms may persist nor if they may be exposed during natural physical processes. In this study, sand cores of approximately 1 m depth were collected at three sites across the beach face in Kitty Hawk, North Carolina before, during and after large waves from an offshore hurricane. The presence of DNA from the fecal indicator bacterium Enterococci was detected in subsamples at different depths within the cores by PCR amplification. Erosion and accretion of beach sand at the three sites also was determined for each sampling day. The results indicate that ocean beach sands with persisting enterococci signals could be exposed and redistributed when wind, waves, and currents cause beach erosion or accretion.