Episodes

  • The Scoop About Poop

    The Scoop About Poop
    Jan 6 2022
    Water, like everything else on Earth, including you, is full of bacteria. But not all bacteria are created equal, with many being more harmful than others. Yes, Escherichia coli (E. coli) pollutes our ground and surface water through fecal contamination, but the bacteria is also simply found and widely distributed in nature. As one of our hosts, Christian, bid adieu to us, his last pathogen of choice is E. coli. Listen in as the bacteria-loving buds discuss strains and characteristics, causes, effects, and environments of this curious bug. More about E. coli: CDC’s summary of E. coli What is E. coli O157:H7? Coliform Bacteria in Drinking Water Supplies Stay tuned for more episodes, posting on the first Thursday of each month. Subscribe to our show wherever you get your podcasts and find more info at weebeastiespodcast.com  The Wee Beasties podcast is a production of Nephros, Inc., a company committed to improving the human relationship with water through leading, accessible technology *** SHOW TRANSCRIPT: Christian:  Kimothy… Kimothy:  Christian… Christian:  Happy New Year. What a year it has been, eh? Kimothy:  Happy New Year, Christian.  Yeah, what a great year.  And a big year ahead – lots of changes.  Including for you – this is your last podcast today, right? Christian:  Yeah, that’s correct. Really sad to have to move on – I think this is such an important forum to have these conversations, and I will miss the opportunity to share microbiology with our audience. Kimothy:  Well, what do you think our Swan Song should be for your last episode? Christian:  I thought E. coli might be a good one to end on.  A well-known, and often misunderstood, waterborne pathogen. Kimothy:  Yeah, no doubt, Christian.  Christian:  So, when I think of E. coli, I immediately go to headlines about spinach recalls and announcements about contaminated meat at restaurants.  But E. coli bacteria can just as easily contaminate a municipal water supply, right?  And E. coli is a gut bacterium, so when something is contaminated, are we just saying that it has gut bacteria or, really, just poop in the water? Help me understand this, is water contaminated with E. coli, just water that has fecal matter in it? Kimothy:  [laughs] Well, yes, essentially.  But, let’s back up for a moment and outline a few things.  So, E. coli is a bacterium that lives in the intestines of warm-blooded animals, and most strains of E. coli bacteria are not harmful and are an essential part of the gut flora for healthy digestion. That said, there are several pathogenic strains, the most common one in the U.S. being a Shiga toxin-producing E. coli called, O157:H7. Now, all E. coli is part of a group I mentioned during our last episode, called coliforms.  Coliforms are a kind of rod-shaped bacteria that are found in soil, plants, and intestinal tracts of animals – in this group you have total coliforms and fecal coliforms.  The most prevalent fecal coliform species is E. coli. And the most dangerous fecal coliform is E. coli O157:H7, so to get back to your question. Yes, it’s poopy water. Christian:  Ahh, I knew it.  So that’s the scoop on poop?  Kimothy:  Well, the gut microbiome has a lot more to it than that, but that’s the scoop on E. coli in water. Christian:  Okay, okay…so, a couple of things at which I’d like to take a closer look. I got that if water has E. coli in it, it is because the water has been contaminated with fecal matter, but you mentioned Shiga toxin E. coli and coliforms.  What is Shiga toxin and why do we care about coliforms? I mean, I don’t want coliforms in my drinking water, but you’ve mentioned coliforms in two episodes now, so I just wanted to pause and ask a little more. What’s the importance here? Kimothy: Sure, Christian.  So, coliforms, as I mentioned encompasses a group of rod-shaped bacteria, and the reason they’re important is, first, they always exist in the digestive tracts of animals and their waste; and second, they are a great ‘indicator’ organism. That is, you can test for coliforms as a diagnostic tool that can give you a read on the probability of other pathogenic organisms being present in your sample.  If you conduct a coliform test and it’s positive, you know on a list of probable outcomes, that there is some risk of contracting a waterborne illness or disease.  Okay, now for the Shiga toxin: The E. coli that produce Shiga toxin are called Shiga toxin-producing E. coli or STEC for short.  The most common type of STEC is O157:H7 and has emerged as one of the most serious causes of severe human gastrointestinal disease. Now, the pathogenesis involves the E. coli bacterium releasing the Shiga toxin in the gut of a human which attacks and destroys the lining of the intestinal tract, resulting in bloody diarrhea. According to the CDC, there are about 70,000 cases of hospitalization from O157:H7 every year in the US. Christian:...
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    10 mins
  • My gal Sal and Typhoid Mary

    My gal Sal and Typhoid Mary
    Dec 9 2021
    “Mary has died of Typhoid Fever”. Ah, yes. If you are of a certain generation, you remember being met with these abrupt notifications while playing Oregon Trail. While this game taught generations of young people about Western migration in 19th-century America, it also familiarized them with various diseases…and, how to avoid getting run over by wagon wheels. This month, our hosts are exploring the root of the cause – diving into species and subspecies of Salmonella. More about Salmonella: CDC’s summary of Salmonella Salmonella Nomenclature Mary Mallon (1869-1938) and the history of typhoid fever Stay tuned for more episodes, posting on the first Thursday of each month. Subscribe to our show wherever you get your podcasts and find more info at weebeastiespodcast.com     The Wee Beasties podcast is a production of Nephros, Inc., a company committed to improving the human relationship with water through leading, accessible technology.  *** SHOW TRANSCRIPT: Christian:  I am back with Dr. Kimothy Smith. Kimothy, welcome back! Kimothy:  Thanks, Christian. What’s new? Christian:  Well, I’ve been combing through the annals of gastroenterology in search of the origin of “Typhoid Mary” and learned a few things I’d like to share. Kimothy:  By all means. What ya got? Christian:  Alright, so check it out, in case you’re not current on your NYC history or your only reference for Typhoid fever was that Oregon Trail game back in the late ’80s…and this is literally from the Annals of Gastroenterology…I’ll throw a link in the show notes – Typhoid Mary was the name eventually given to a woman named, Mary Mallon who lived in NYC in the early 1900s and became notorious as a healthy carrier of Salmonella thypi – the bacterium that causes Typhoid fever. She was an immigrant, not necessarily well off, and was employed as a cook for wealthy families. Now, this was before a vaccine was available and before antibiotics. An investigation had started because there were many people getting sick with a fever, and the investigator trying to track down the source noticed there were pockets of families employing the same cook. Mary was leaving after the infection had occurred to move on to a new family to cook for them. In the end, there were 122 people infected, 5 dead. And that year over 3,000 people in NYC had become infected in 1907 – she was apparently the source. What’s interesting is that there was no tracking mechanism in place, so investigations had to be done just by a small group or single man. There was an assumption that a microorganism was suspected of being responsible, but nobody knew why. The investigation really corroborated that hypothesis which eventually came from a team of veterinary scientists. So, in 1880, this guy Daniel Elmer Salmon ended up naming Salmonella typhi as a consequence of this investigation. Kimothy: Sticking with your history bend for a minute, this is not so long after the cholera plague in London. Germ theory was still a controversial thing, they thought it was neighbors. So, go vets! Real doctors treat more than one species. Kimothy:  So, if you haven’t inferred already, we’re going to give you a snapshot of Salmonella today. Salmonella enterica, specifically. Christian:  Yeah, so…a query sir.  As I was sifting through literature, I didn’t see a lot of mention of enterica early in the investigation of Typhoid fever.  Can you summarize how Salmonella enterica became the catch-all for all the varieties of Salmonella? Kimothy:  Yeah, it’s a bit unusual because as you said, Christian, the initial outbreak investigation resulted in named in Salmonella typhi and now we have Salmonella enterica. It’s important to remember that science naming conventions are like kaleidoscopes – the contents remain the same, but the picture and how it’s described change depending on who’s holding the instrument. Such has been the reshuffling with Salmonella. Most of the scientific community now breaks Salmonella into two species Salmonella bongori and Salmonella enterica into 6 subspecies and over 2600 serotypes. But essentially it comes down to two groups – Salmonella that causes gastroenteritis and then those that cause enteric fevers. Christian:  Which patient populations are most at risk for acquiring Salmonella? Kimothy:  The CDC estimated that Salmonella causes 1.2 million illnesses and 450 deaths annually in the US.  Anyone can become infected with the bacteria – fecal-oral and food & water are the most common routes. The populations at greatest risk are typical demographic we’ve discussed for all our opportunistic pathogens – those under the age of 5 and over the age of 65, and those with weakened immune systems. Christian:  And how does it present? Kimothy:  So, the gastrointestinal infection that results when you ingest the bacteria is Salmonellosis, and it presents exactly how you would expect for a pathogen...
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    12 mins
  • Camp-tastic

    Camp-tastic
    Nov 4 2021
    Ready to think twice about the filtration used to treat your water for consumption? Ready or not, our hosts are exploring the gut microbe, Campylobacter jejuni. This gram-negative bacterium is about 0.2um – 0.5um in size. Small, but mighty enough to warrant the use of a 0.05um filter if you want to catch this bug and potentially avoid some stomach souring symptoms. More about Campylobacter jejuni: What is Campylobacter infection? Safewater.org | Campylobacter Fact Sheet Stay tuned for more episodes, posting on the first Thursday of each month. Subscribe to our show wherever you get your podcasts and find more info at weebeastiespodcast.com    The Wee Beasties podcast is a production of Nephros, Inc., a company committed to improving the human relationship with water through leading, accessible technology. ***  Campylobacter jejuni, Campylobacter, biosurveillance, microorganisms, biotechnology, PremisePlumbing, AntonVanLeeuwenhoek, WeeBeastiesPodcast, season1, origins, CDC, pathogens, OpportunisticWaterbornePathogen *** SHOW TRANSCRIPT: Christian: I am back with Dr. Kimothy Smith. Kimothy, welcome back! Kimothy: Thanks, Christian. Christian: All right…how are we doing today Kimothy?  Kimothy: Doing well, Christian. Just recovering. Christian: Recovering from what? Kimothy: All of the candy corn I had to pick up in my front yard this weekend. The local monsters and ghouls decided it was imperative that my lawn be seeded with candy corn so they could apparently revive a Children of the Corn montage for Halloween.  Of course, nothing was going to grow except the number of birds and bugs on my lawn, so I found myself bent over cleaning that crap up all day on Sunday. Sigh. Christian: Well, hey, out of the Steven King flicks to choose from that was probably the best.  I mean, at least they didn’t choose to revive the film It, your front yard would have been littered with psychopathic clowns with red hair and pointy teeth. It can always be worse, Kimothy. It can always be worse. Well, enough with the candy corn and clowns…what is our pathogen for today? Kimothy: Campylobacter jejuni Christian: Campylobacter is always associated with camping and environmental infections for me.  I just remember the camp in Campy and immediately remember that these infections are uncommon for treated water networks, but more likely found in untreated settings like stagnant environmental samples. Kimothy: Yeah, Christian, this bacterium doesn’t tend to survive in treated water systems very well; and, if it does, it is in a viable but non-culturable state.  This is a gut microbe and it’s primarily transmitted through birds, cattle, and other livestock feces – but, poultry mainly, such as chickens and turkeys. Feces from these animals shed campylobacter in into streams, rivers, lakes, and reservoirs. The most common route of infection is through ingestion (fecal-oral), whether that is untreated water or contaminated food. The result is campylobacteriosis – an acute illness that causes nausea, abdominal pain, fever, cramping, and diarrhea.  The abdominal pain can be so debilitating that it is often confused with appendicitis. Christian: Alright, so, in treated water there is less of a concern, but it’s still possible to become infected in untreated water sources. What about its cellular structure and behavior; is this something I can easily filter out of the water supply I’m drinking from? Kimothy: Well, this is another gram-negative, spiral, and rod-shaped bacterium that is about 0.2um – 0.5um in size, so you’ll want a 0.05-micron filter if you want to catch this bug before using the water for consumption.  Its motile by a single flagellum, and is not a good biofilm producer, so it’s constantly on the move for nutrient sources.  It’s most happy in intestinal tracts of animals, like I mentioned early, so livelihood is challenging for it in bulk water systems. That said, it doesn’t take much ingestion to make you symptomatic and acutely sick.  I believe Safewater.org reports that less than 500 cells consumed will result in symptoms. To that end, I’d like to deviate just for a moment and emphasize Campylobacter is the most common bacterial cause of diarrhea in the U.S., affecting 1.5 million residents a year.1 And, a not well-known mode of transmission for shedding Campylobacter is our pets, in particular, our dogs. Christian: Ahhh, so all those people out there that are convinced your dog licking your face is OK, and just a warm sign of affection and love – it's probably true, but it comes with the bonus of acute diarrhea and cramps!  Nice.  Well, pooches aside, which patient populations are most at risk for acquiring Campylobacter? Kimothy: So, nothing surprising here, Christian.  Immunosuppressed or compromised patients are at greatest risk (think cancer and AIDS patients), but also pediatrics -- specifically those under the age of five are ...
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    9 mins
  • Bacter to the Future

    Bacter to the Future
    Oct 7 2021
    Time to talk about the most widespread infection in the world, Helicobacter pylori. Following the accidental abandonment of incubated plates, H. Pylori colonies were discovered, launching a larger investigation into the microbiology of the human stomach. More research is needed on this disease-causing gram-negative bacterium, but our hosts provide the basics of its characteristics, transmission routes, and prevention in this episode.   More about Helicobacter pylori: Persistence strategies of the bacterial pathogen Helicobacter pyloriGastroenteritis and Transmission of Helicobacter pylori Infection in HouseholdsNobel prize is awarded to doctors who discovered H pyloriPathogen Safety Data SheetsTrends in Hospitalizations for Peptic Ulcer DiseaseH pylori finds its home  Stay tuned for more episodes, posting on the first Thursday of each month. Subscribe to our show wherever you get your podcasts and find more info at weebeastiespodcast.com   The Wee Beasties podcast is a production of Nephros, Inc., a company committed to improving the human relationship with water through leading, accessible technology. ***   SHOW TRANSCRIPT: Christian: I am back with Dr. Kimothy Smith. Kimothy, welcome back!  Kimothy: Thanks, Christian.  Christian: All right…how are we doing today Kimothy? How’s life?  Kimothy: I’m feeling a lot of stress, and I’ve got a pain in my stomach. I think I’m getting an ulcer.  Christian: Today’s the right day to have this conversation, I think. We’re talking about pathogens on this podcast, so I hear?  Kimothy: Cool! Let’s go.  Christian: I was watching that documentary, Human Nature, last night. Have you seen it yet? It’s about genomics, personalized medicine using CRISPR cas9 and the scope of genetic and molecular engineering to cure disease, but also do wild projects like bringing back a wooly mammoth. Cool stuff. Worth a watch if you have some time.  Kimothy: I’ll check it out, but I tend to be a bit old school. And, I don’t mean to go too deep on the old school stuff here, but, have you seen Jurassic Park? Do you really want to bring back a wooly mammoth?  Christian: What is that line from Jeff Golblum in Jurassic Park? “Your scientists were so preoccupied with whether or not they could, they didn’t stop to think if they should?”  Kimothy: Yeah, definitely.  Christian: Well, what’s our next waterborne pathogen?  Kimothy: Apropos to my ulcer generation, it is Helicobacter pylori.  Christian: H. pylori, I’m not super familiar with this one, but if memory serves this is spiral-shaped bacteria that makes a home in your stomach and can cause ulcers and even stomach cancer in some cases, right?  Kimothy: Yeah, you’re on the right track, Christian. According to a 2013 report1 in Nature, H. pylori is the most widespread infection in the world, infecting at least half of the global population. The World Health Organization (WHO) recognized H. pylori as a group 1 carcinogen in 1994, but the backstory on this little bug isn’t that straight forward.  H. pylori was discovered more recently, in comparison to the other microorganisms we’ve discussed – it was discovered in 1983 – and, interestingly enough, it was first found as a colony in the human stomach in a really unexpected stroke of luck after two doctors were trying to demonstrate a connection between the severity of gastric distress experienced by their patients and the number of bacteria present. In part, this discovery prompted scientists to begin a larger investigation into the microbiology of the human stomach using 16S rRNA analysis – and now we know that the stomach and the rest of the human gut has an extraordinarily diverse microbiome of bacteria which is critical to our immune response and other autonomic faculties. And I must tell you, Christian, as a side note, I’ve heard an urban legend that your microbiome can determine if you have a sweet tooth or not. Have you heard that?  Christian: I have not, but I’ve got a horrible sweet tooth. I’m always wanting sweets. So, I’m sort of wondering if we should run a 16S rRNA analysis of my gut biopsy.  Kimothy: Keep your microbiome to yourself, please.  Christian: Yeah, so this was part of what catalyzed the gut microbiome frenzy in the 90’s. But wait, what was the stroke of luck? And, if good bacteria is so critical to our gut and immune response how is H. pylori, a pathogenic bacterium, able to stay alive in there?  Kimothy: Yeah, Christian, I’m glad you asked. So, the stroke of luck was in the successful culture. The two Australian doctors credited with the discovery just mistakenly left a plate in the incubator a lot longer than they had intended, and they just happen to get H. pylori colonies on it.  Those that have worked with H. pylori before ...
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    13 mins
  • Lp the OG

    Lp the OG
    Sep 2 2021

    This month, Dr. Kimothy Smith and Christian Railsback explore a well-known pathogen to healthcare facilities worldwide, Legionella pneumophila (Lp). Premise plumbing systems serve as the coziest of homes to this harmful and sometimes deadly bug, making routine biosurveillance efforts a must. Our hosts take a deep dive into the metabolic and cellular composition, preferred habitats, harmful effects, and preventative measures of Legionella pneumophila. A transcript of the conversation appears below.

    More about Legionella pneumophila:

    • Water [a peer-reviewed, open access journal on water science and technology]
    • Living with Legionella and Other Waterborne Pathogens
    • Epidemiology and Ecology of Opportunistic Premise Plumbing Pathogens
    • Legionella pneumophila: The Paradox of a Highly Sensitive Opportunistic Waterborne Pathogen Able to Persist in the Environment
    • Vital Signs: Health Care–Associated Legionnaires’ Disease Surveillance Data from 20 States and a Large Metropolitan Area 

    Stay tuned for more episodes, posting on the first Thursday of each month. Subscribe to our show wherever you get your podcasts and find more info at weebeastiespodcast.com .

     The Wee Beasties podcast is a production of Nephros, Inc., a leading water technology company providing filtration and pathogen detection solutions to the medical and commercial markets.  
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    15 mins
  • An Interview with Dr. Paul Sturman of the CBE

    An Interview with Dr. Paul Sturman of the CBE
    Aug 5 2021

    In this episode our hosts are joined by Dr. Paul Sturman, Research Professor and Industrial Coordinator at the Center for Biofilm Engineering (CBE), to discuss biofilms and their relationship to the CDC’s list of opportunistic pathogens. This season, Dr. Kimothy Smith and Christian Railsback have been dissecting this list of pathogens, specifically those that cause disease. Biofilms are a big part of the microbiome of premise plumbing systems and the different concentrations of bulk water pathogens. Dr. Sturman’s extensive research and knowledge of these slimy communities of microorganisms offer insightful points about biofilms, pathogens, and how they affect the systems in which they grow.

    More about biofilm consortiums:
    National Biofilms Innovation Centre
    Singapore Centre for Environmental Life Sciences Engineering
    Costerton Biofilm Center
    Center for Biofilm Engineering

    Stay tuned for more episodes, posting on the first Thursday of each month. Subscribe to our show wherever you get your podcasts and find more info at weebeastiespodcast.com

    The Wee Beasties podcast is a production of Nephros, Inc., a leading water technology company providing filtration and pathogen detection solutions to the medical and commercial markets.

    ***
    SHOW OUTLINE:

    Today’s episode features a conversation with Dr. Paul Sturman, a Research Professor and Industrial Coordinator at the Center for Biofilm Engineering (CBE). Dr. Paul Sturman began his impressive line of work in Forestry, operating in the wood products industry before pursuing his master’s in environmental engineering at Montana State University. While completing post-grad bioremediation work of soil and groundwater and working as research faculty at MSU, Dr. Sturman received project funding through the U.S. Environmental Protection Agency (EPA), allowing him to advance his environmental engineering education by obtaining his PhD. Currently, Dr. Sturman serves as Research Professor and Industrial Coordinator at the Center for Biofilm Engineering (CBE) in Bozeman, MT. He currently works on a NASA-funded project, attempting to answer how biofilm growth compromises the wastewater system.

    Our discussion covers:

    • Sturman’s background and expertise in biofilm research
    • Current projects at the Center for Biofilm Engineering (CBE)
      • Examining how biofilm growth compromises the wastewater system
      • Collaborations with government organizations (NASA, the EPA and FDA)
      • Collaborations with international biofilm organizations (NBIC, SCELSE, and Costerton Biofilm center in Denmark)
    • What is a biofilm?
    • Biofilm characteristics
      • What encourages proliferation?
      • What does and does not penetrate biofilm?
    • Biofilm producers
      • Pseudomonas aeruginosa and coli as biofilm producers
    • How do you identify the other organisms present in the microbiome?
      • Using PCR to identify present microorganisms
      • Proteomics techniques help identify which microorganisms are active and what they are doing
      • 3D imaging as a burgeoning method of identifying the structure and behavioral growth of the biofilm
      • Using probes to sense the biofilm in real-time, and as a means of observation and measurement
    • Biofilms challenges in the hospital environment
    • CBE focal points for the future
      • More biofilm education is critical to private industry and the general population
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    52 mins
  • Klebsiella and the Club of Antibiotic Resistance

    Klebsiella and the Club of Antibiotic Resistance
    Jul 1 2021
    In this episode, Dr. Kimothy Smith and Christian Railsback discuss Klebsiella – a gram-negative bacteria that causes various healthcare-associated infections. Though Klebsiella has a broad scope at the species and sub-species levels, this episode concentrates on common characteristics, environments, and levels of drug resistance. A transcript of the conversation appears below. More about Klebsiella:CDC’s Opportunistic Pathogens of Premise Plumbing listKlebsiella pneumoniae in Healthcare SettingsKlebsiella Pneumonia Stay tuned for more episodes, posting on the first Thursday of each month. Subscribe to our show wherever you get your podcasts and find more info at weebeastiespodcast.com The Wee Beasties podcast is a production of Nephros, Inc., a leading water technology company providing filtration and pathogen detection solutions to the medical and commercial markets. ***SHOW TRANSCRIPT: Christian:  I am back with Dr. Kimothy Smith. Kimothy, welcome back! Kimothy:  Thanks, Christian. Christian:  So, what’s our bug for today? Kimothy:  Klebsiella. Christian:  Klebsiella. Reminds me of something I would get whacked with by my grandmother. Kimothy:  Well, Christian, Klebsiella is likely slightly more insidious than your grandmother, it can lead to meningitis.  But I don’t know I never met your grandmother.  Christian:  You’re right, that’s slightly more insidious than my grandmother. Okay, I’m really interested to hear how Klebsiella leads to meningitis or other pathologies of similar mortality and morbidity. But let’s start small today. Let’s make this easily digestible. This is a waterborne pathogen like the previous pathogens we’ve discussed. How do we differentiate this bug? Kimothy:  Let me first say the genus, Klebsiella, has a fairly broad scope and extensive list at the species and sub-species levels. For the purpose of remaining very clear I’ll limit my descriptions to the most clinically significant species and sub-species. Namely, K. pneumoniae and K. oxytoca. Both of which can be pronounced in different ways, by different people. Part of the justification for limiting to just these two is that 90% of the waterborne pathogen infections caused by Klebsiella are these two species. Christian:  Okay, so that means the microbiologists out there are going to express scorn for our unwillingness to spend the full day discussing the catalogue of attributes across the genus, right? So, keeping in mind this is a 30,000’ discussion, what’s at the cellular level, what kinds of characteristics stand out? Kimothy:  Well, Klebsiella’s most immediate visual cue is its rod-shape and capsule.  Its capsule is meant, in part, to protect it from hostile environments.  Klebsiella thrives in the gastrointestinal tracts of a wide range of animals, including our own. And consequentially it’s also found in wastewater, soil, and then of course therefore, fruits and vegetables as well. Since it predominates these areas, it easily integrates into the water cycle and in particular municipal water networks. The capsules also promote biofilm development which allows it to better protect itself and easily persist in water distribution systems despite heavy chlorination. Like the other pathogens we’ve discussed this too is a gram-negative bacterium.  And it’s non-motile, so it really depends on the biofilm for protection and nutrients. Christian: Biofilms keep coming up. I assume it’s not a coincidence that the CDC is emphasizing non-motile biofilm producers on its list of most concerning waterborne pathogens? Kimothy:  Yes, that’s right, Christian. And I’ll just add that another common feature we’ll begin to see many of these bacteria share is the ability to resist antibiotics. Klebsiella is no exception. It is among the most resistant to antibacterial agents. Most recently to a class of antibiotics known as carbapenems.   Christian:  This is I suspect, in part, why we see so many healthcare-associated infections resulting from Klebsiella. Long-term care facilities, hospitals, clinics, and places where antibiotics are used, I imagine that’s why Klebsiella persists so much. So, tell me a little about the epidemiology. What kinds of illnesses are caused? Kimothy:  So, I mentioned earlier that Klebsiella does exist in the human GI tract, but this does not cause disease. Klebsiella really only becomes a problem when it’s (like meningitis) transmitted in the blood or inhaled.  So, serious blood infections and acute pneumonia are the biggest concerns. Particularly, patients needing long-term, recurring infusions or patients on ventilators are most susceptible. Also, individuals with liver disease and are hospitalized are known to get liver abscesses as a result of Klebsiella.  Christian:  Okay, so if I’ve got this right, I’ve got Klebsiella in my gut right now, but it’s essentially benign there because it really can’t take root and cause disease, but if it...
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    12 mins
  • NTM, Auntie Em!

    NTM, Auntie Em!
    Jun 3 2021
    In this episode, Dr. Kimothy Smith and Christian Railsback discuss non-tuberculosis mycobacterium (NTM) and how it differs from a gram-negative bacterium, like Pseudomonas.  Cell structure, metabolic Mycobacterium avium performance, exploiting biofilms, and culturable but non-viable cells are among the high points on the pathogen odyssey today. A transcript of the conversation appears below. More about Mycobacterium: CDC’s Opportunistic Pathogens of Premise Plumbing listMycobacteria MLST Scheme — Typing; Isolate and Genome CollectionsThe 2015 Study — Epidemiology and Ecology of Opportunistic Premise Plumbing Pathogens: Legionella pneumophila, Mycobacterium avium, and Pseudomonas aeruginosa Stay tuned for more episodes, posting on the first Thursday of each month. Subscribe to our show wherever you get your podcasts and find more info at weebeastiespodcast.com The Wee Beasties podcast is a production of Nephros, Inc., a leading water technology company providing filtration and pathogen detection solutions to the medical and commercial markets. *** SHOW TRANSCRIPT: Christian:  I am back with Dr. Kimothy Smith. Kimothy, welcome back! Kimothy:  Thanks, Christian. Christian:  So, what’s our bug for today? Kimothy:  Non-tuberculosis mycobacterium. (NTM) Christian:  Okay, NTM. What is NTM? Kimothy:  NTM actually includes 125 different species of mycobacteria. Essentially all of the mycobacteria that do not cause tuberculosis or leprosy, also known as Hansen’s disease are included in the NTMs. Christian:  Interesting, so it seems like there could be a lot of ground to cover here.  Are there certain types of this mycobacteria that are more likely to exist in potable water and cause infections? Kimothy:  Yes, it’s actually very complex and more than we can cover in this podcast. But, we can get a start and a little bit of a taste, so to speak, for NTM. In NTM’s, the one most likely to cause a health issue in water is called Mycobacterium avium — it is actually a complex, Mycobacterium avium complex (MAC).  It can be found in fresh and saltwater, as well as in soil or dust, too. Like Pseudomonas, these are biofilm producers, and they use this as a niche to colonize. Particularly because they can take advantage of protozoa and amoebae that are motile. MAC behave as intercellular parasites and use them to colonize. Christian:  And at the cellular level, what kinds of characteristics stand out? Kimothy:  Well, different from our last bug, Pseudomonas, MAC is a gram-positive bacterium and non-motile.  But it is rod-shaped, like Pseudomonas was. Perhaps one of the most notable features at the cellular level is its slow growth rate and slow cellular metabolism. Where some bacteria might reproduce every 20 minutes, the mycobacteriums are usually measured in hours, and sometimes even a day or more, for them to reproduce. So, this is really slow. This is noteworthy because it allows the bacterium to gradually uptake and process any antibiotics and disinfectants in its habitat, resulting in the bug being very resilient in an environment treated with antimicrobial agents.  It also produces mycolic acids that coat the cell surface in a kind of wax, increasing its cellular defense – antibiotics and disinfectants can’t penetrate it as easily. Christian: It sounds like it’s a pretty difficult bacteria to kill. Would one be able to use chloramine or superheating to address NTM in their water supply? Kimothy:  Many remediation methods are not effective in removing NTM from building plumbing.  In fact, some remediation methods may remove competing microbes and result in increased concentrations of NTM in the water. So they take advantage of the depression of the other bacteria in the community and they fill that void. Still, other methods such as treating water with chlorine or chloramine are ineffective, too.    Christian:  The bug has a waxy protective coating, a slow metabolic engine that allows it to resist antibiotics, and it’s really tolerant to chlorine and chloramine treatments.  This is an impressive set of defenses.  Is there anything else? Kimothy:  Well, two more things, actually. Remember that I mentioned MAC produces mycolic acid as an additional protective barrier on its cell membrane? Well, that is also an essential component to the formation of biofilms, which it uses to both protect itself and enhance colonization and translocation, so when pieces of the biofilm break off. Lastly, MAC is sometimes not easy to culture because the cells enter a state of VBNC, or Viable but Non-Culturable.  This is usually because several treatment modalities have been used in the water or nutrients are in short supply, so the cell operates in a dormant, but a still viable condition. This is one of those worst-case scenarios because when you send samples to a lab to be cultured there is no indication pathogens are in your premise plumbing. So, yes, this is a really complex bug to ...
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    10 mins