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This Infection Lives In Your Shower. A Different Bacterium Could Be The Cure

In the future, those with respiratory problems or compromised immune systems may not have to worry about an unwanted MAC attack.

09/21/2017 14:22 EDT | Updated 09/21/2017 14:28 EDT
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There's nothing quite like a nice hot shower after a long day. The relaxing flow of the water can help to relax muscles, bring a sense of peace to the mind, and of course, help to clean off dirt, grime, and those smelly bacteria. Yet, even as you shed the bacterial load from your body, in some cases, you may be breathing in some potentially pathogenic species spraying from the shower head.

Together, they are known as the Mycobacterium avium complex or MAC for short. As you may deduce, they are related to the infamous bacterium, Mycobacterium tuberculosis, which is the cause of TB. You may not have heard about the MAC but in Canada, thousands of people are affected.

Thankfully, the effects of these bacteria are not as dire as tuberculosis. For the most part, those who are infected must deal with a constant cough. However, in more severe cases the onset of fever, fatigue, weight loss can occur. In the most serious type of infection, known as disseminated MAC, the liver, bones, and brain may be affected. These more worrisome symptoms thankfully are quite rare. However, treating this type of infection is incredibly difficult meaning those suffering have a long and difficult struggle ahead.

For most of Canada's history, the MAC has caused little worry. However, the rate of infections began to increase in the later part of the last century. This mainly has been due to the expected rise in people suffering from compromised immune systems and respiratory diseases. The lack of a strong and balanced immunity allows for these species to take hold in the lungs and lead to symptoms.

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The concern over this microbial complex has led the government of Canada to issue guidelines on how to control the MAC in residential water systems. Unfortunately, the most effective treatments, such as heat and ultraviolet light are not used universally. This means the bacteria can enter the distribution system and pose a risk for respiratory exposure.

But this isn't the worst part. Once these bacteria make it into the plumbing system, they can form biofilms such that their numbers amplify dramatically. When this happens, the risk for exposure during a shower is significantly higher. Also, the options for control are quite limited due to the difficulty of reaching and treating the water distribution system.

Although the situation may appear to be hopeless and thousands of Canadians may have to deal with the risk of yet another pathogen, there may be another option to help control the MAC. The answer isn't in the form of another disinfection technique, mind you. It lies in the form of another type of bacteria.

Species that does not like this pathogen, not at all

The name of this bacterial genus is Methylobacterium and thanks to an international team of researchers, it may offer the chance we need to keep the complex from causing infections. The trick, as the group found, has to do with a rather interesting phenomenon occurring at the microbial level. This species does not like the MAC and has a means to prevent it from growing.

The research group had known for some time that the main species in the MAC, Mycobacterium avium, never seemed to occupy the same space as Methylobacterium. This led the team to investigate what was causing this lack of co-habitation. The group performed experiments in the lab using conditions similar to those found in plumbing to ensure the results could be interpreted correctly.

As for the procedures themselves, the process was rather simple. The team allowed Methylobacterium to grow on surfaces similar to those found in plumbing pipes. They immersed the bacteria-coated surfaces in tap water and added a variety of bacteria and yeasts including M. avium. Then, they let them sit for three weeks, which would be plenty of time for the complex to grow. At the end of the time, the group looked for any signs of growth in comparison to control.

The results were fascinating. Just as expected, the presence of Methylobacterium prevented the formation of M. avium biofilms. However, what was surprising was how this was accomplished. Unlike what was believed to occur, there was no killing of the pathogen. Instead, the something produced by the methylobacteria was preventing the avium species to take hold.

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But the best was yet to come. Normally, when inhibition such as this is observed, there needs to be viability. In other words, the Methylobacterium would have to be alive to prevent the pathogen from forming a biofilm. But in these experiments, only the presence of cellular fractions was needed.

This result meant treatments could be used in the same vein as a probiotic. By inoculating Methylobacterium into the water system, the MAC would be unable to form a biofilm. As a result, the plumbing system would be considered safe.

Although this study offers some perspective on how to control the MAC, don't expect to see Methylobacterium in hardware stores anytime soon. This work, while promising, still is a proof of concept. More work needs to be done in real plumbing systems to determine whether this process can be effective. But, in the future, those with respiratory problems or compromised immune systems may have the chance to enjoy that hot shower without the worry of an unwanted MAC attack.

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