Elena N. Naumova, Ph.D.
With funding from NIEHS, a new analysis of 100 million Medicare records from U.S. adults aged 65 and older revealed rising healthcare costs for infections associated with pathogens that can live in household or building plumbing. Based on their findings, the authors call for an urgent dialog across governmental and disciplinary divides and for more studies on preventing exposure to opportunistic pathogens in home and building plumbing through drinking water exposure.
Although modern water treatment facilities rid water of fecal-borne pathogens, the pipes and fixtures in home and buildings — known as premise plumbing systems — can harbor microorganisms such as Legionella pneumophila, Mycobacterium avium, and Pseudomonas aeruginosa. These opportunistic premise plumbing pathogens live in the inner surfaces of pipes where they can aggregate and grow as microbial biofilms, making them resistant to antibiotics and disinfectants and able to withstand environmental stresses.
The researchers found that between 1991 and 2006, more than 617,000 hospitalizations related to L. pneumophila, M. avium, and P. aeruginosa resulted in around $9 billion in Medicare payments, an average of $600 million a year. Antibiotic resistance, which was reported for less than two percent of hospitalizations, increased the cost per case by between 10 to 40 percent. The researchers hypothesize that the antibiotic resistance may occur because organisms growing in a biofilm can transfer genetic elements, including antibiotic resistance genes.
Citation: Naumova EN, Liss A, Jagai JS, Behlau I, Griffiths JK. 2016. Hospitalizations due to selected infections caused by opportunistic premise plumbing pathogens (OPPP) and reported drug resistance in the United States older adult population in 1991-2006. J Public Health Policy; doi:10.1057/s41271-016-0038-8 [Online 12 September 2016].