One proposed control method for OPPPs is simply to raise the temperature of hot water systems.
Some hospitals use a 0.2-[micro]m microbiological filter, such as those made by Pall Medical, on showerheads and faucets in patient rooms to block OPPPs. Steve Ebersohl, senior director of hospital sales with Pall Medical, says physicians who treat OPPP patients can refer them to that company or other manufacturers to learn how to add these filters to their home plumbing fixtures.
He hopes those same solutions also may prevent widespread public health impacts associated with emerging OPPPs, such as multidrug-resistant Acinetobacter, which has infected soldiers who were wounded serving in the Middle East.
Materials such as this may be one way to keep OPPPs from colonizing plumbing systems.
Information available for disease incidence for each bacterial OPPP that we focus on in this review are listed in Table 1, with two amoebal OPPPs also indicated for comparison as emerging and serious health threats.
There are several traits shared by the three bacterial OPPPs that select for their presence and persistence in premise plumbing.
Currently, there are no documented broadly effective community-level engineering control strategies for OPPPs in municipal drinking water or premise plumbing.
One outcome of the 2012 expert workshop sponsored by the Water Research Foundation was a listing of research gaps in our under-standing and knowledge of the bacterial OPPPs (Pruden et al.
Although the focus of the workshop and this review is on three OPPPs, there are other opportunistic pathogens in premise plumbing.
One novel research concept that was identified by the workshop was the possibility that the microbiome of a water distribution system or premise plumbing could be manipulated to influence the presence of OPPPs. Studies of that type might provide understanding of the distribution system microbiome to aid in predicting when colonization by OPPPs would be favored.
Appendix 1: Recommended Research Projects Related to Epidemiology and Ecology of OPPPs
* Determine the prevalence, incidence, and trends of disease caused by OPPPs