Letters in Applied Microbiology 1999, 29, 81–84
The occurrence of fungi in hospital and community potable
waters
M. Arvanitidou, K. Kanellou, T.C. Constantinides and V. Katsouyannopoulos
Laboratory of Hygiene, Medical School, Aristotelian University of Thessaloniki, Greece
2102/99: received 18 February 1999, revised 5 May 1999 and accepted 5 May 1999
M. ARVANITIDOU, K. KANELLOU, T.C. CONSTANTINIDES AND V. KATSOUYANNOPOULOS. 1999.
The prevalence of fungi was investigated in 126 potable water samples (84 hospital and 42
community samples), in parallel with the standard pollution indicator micro-organisms.
Filamentous fungi were isolated from 104 of 126 (82·5%) samples and yeasts from 14 (11·1%),
whereas their mean counts were 36·6 and 4·4, respectively. Fungi were isolated from
95·2% of community and 76·2% of hospital water samples, with the difference being
statistically significant (P ³ 0·05), while yeasts were isolated from 9·5 and 11·9%,
respectively. Prevailing genera were Penicillium spp., isolated from 64, Aspergillus
spp., from 53, and Candida, from nine of the examined samples. Colony-forming units
of yeasts were significantly correlated with those of total and faecal coliforms, whereas the
counts of filamentous fungi were significantly correlated with total heterotrophic
bacteria counts. These results suggest that tap water is a potential transmission
route for fungi both in hospitals and the community in the examined region and may
pose a health hazard mainly for the immunocompromised host.
INTRODUCTION
Fungi are an emerging cause of hospital-acquired infection
in the 1990s. Although endogenous infection following colon-
ization is the prevailing mode of fungal transmission, exogen-
ous acquisition may occur and result in outbreaks (Muittari
et al. 1980; Macher and Girman 1990; Beck-Sague et al.
1993). Fungi are natural inhabitants of soil and water and
some species behave as opportunistic pathogens in man.
Fungi grow in water systems where there are dead spaces and
parts of the pipework that have low circulation. Furthermore,
the materials forming tanks and washers can contribute to
biofilms containing fungi through the slow release of organic
material (Niemi et al. 1982). With the increasing number of
patients undergoing complex medical therapy, more unusual
infectious disease processes have emerged. Fungal pathogens
as agents of a variety of infections are part of this trend
and are found much more frequently as the cause of both
community- and hospital-acquired infections in immuno-
compromised patients.
In the present study, the total heterotrophic bacteria, total
coliform and faecal coliform counts were estimated in parallel
Correspondence to: Prof. M. Arvanitidou, Laboratory of Hygiene, Medical
School, University of Thessaloniki, 54006 Thessaloniki, Greece
(e-mail:vayonaa ¨med.auth.gr).
© 1999 The Society for Applied Microbiology
with the counts of yeasts and fungi in drinking water. The
main objectives of this study were to find the prevalence of
yeasts and fungi in potable water samples, to compare the
occurrence of these pathogens between hospital and com-
munity tap water samples and to investigate the correlation
of yeasts and fungi with the standard indicator bacteria.
MATERIALS AND METHODS
Isolation procedures
The presence of fungi was investigated in 126 water samples
in parallel with the standard indicator bacteria. Forty-two of
the samples were community and 84 hospital tap water
samples. Water was sampled after 3–5 min of free flow
through a distribution system tap. Before sampling, a solution
of sodium hypochloride (100 mg NaOCl l
-1
) was applied to
the tap and the water run for an additional 2–3 min after
treatment. Gloves and long sleeves were worn when collecting
the samples to prevent skin bacteria from contaminating the
samples. The membrane filter technique was employed for
yeasts and fungi (American Public Health Association 1995).
A volume of 100 ml of the samples was filtered, in duplicate,
through membrane filters with pores 0·45 mm in diameter.