Background: Hospital water is increasingly accepted as a source for pathogens. To prevent infection by tap water, severely immunocompromised patients often receive bottled mineral water under the assumption that this is not contaminated. In order to assess the risk of infection by this water, we investigated the presence of bacterial (including Legionella species) and fungal contamination of 68 commercial mineral waters, one tap water and one water sample from a natural well from 16 countries. Methods: Bottled mineral water from 9 European countries (Norway (12), France (13), Italy (11), Germany (3), Greece (6), Austria (3), Spain (1), Hungary (3), Turkey (4), total 56 bottles) and from 7 non-European countries (India (4), Morocco (2), Australia (1), Canada (2), Tanzania (1), Mexico (3), Cuba (1), total 14 bottles). All samples were processed in a biohazard cabinet and filtrated with a sterile 0.2μm filter. Filters were resuspended in pyrogen free sterile water and used for general bacterial culture, Legionella culture, fungal culture, Legionella pneumophila PCR, panfungal PCR (18S), Aspergillus antigen and Legionella antigen detection. Results: All bottles appeared to have been sealed properly which excludes the possibility of contamination after the production process. Overall 40% of all samples showed evidence for contamination with either bacteria (37%) or fungi (4%). Bacteria grew from 21 samples: coagulase negative staphylococci (8), Gram-negative nonfermenters (10) and gram positive rods (9). L.pneumophila DNA was detected in 6 samples and Legionella antigen in 6, but only 2 samples were PCR and antigen positive. Moulds were detected in 3 samples (Penicillium sp (2), non-speciated (1)), but Aspergillus antigen was not detected in any of the samples. Conclusions: High levels of bacterial contamination, including Legionella sp, was present in commercially bottled mineral water and may pose a health risk to certain patient populations.
Full conference title:
44th Interscience Conference on Antimicrobial Agents and Chemotherapy
- ICAAC 44th