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Fungi in water pose great risk to immune-compromised individuals

24 July 2023 | Story André Damons | Photo Supplied

Yeast and other filamentous fungi, which pose a great risk to the health of immune-compromised or suppressed individuals, can be found in various drinking water sources such as ground, spring, surface, and tap water. These opportunistic pathogens may cause severe to fatal infections and can range from superficial to bloodstream or systemic infections.

This is according to Tyla Baker, a postgraduate student in the Department of Microbiology and Biochemistry at the University of the Free State (UFS). She is studying for her MSc degree in Microbiology under the supervision Prof Carlien Pohl-Albertyn, National Research Forum (NRF) SARChI Research Chair in Pathogenic Yeasts. Prof Jacobus Albertyn and Dr Jolly Musoke are her co-supervisors.

Baker says the fungi in the water highlights that current water treatment processes are not efficient in their removal from water destined for household use. “These infections may not be harmful to people with healthy immune systems, but do pose a great risk to the health of immune-compromised or suppressed individuals.

Definite possibility to contract fungal infections from polluted water

“As the number of people with immune systems that are less functional (e.g. premature babies, elderly persons, people with cancer, diabetes or other serious diseases, HIV+ persons, transplant patients) increases, the number of people at risk of fungal infection also increases,” says Baker.

According to Baker, a previous study done in Brazil has identified yeast in bottled mineral water as well as municipally supplied tap water. The potential risk to contract fungal infections from polluted water sources is a definite possibility but more research is required to fully understand and determine the level of risk and the extent of its effects, she says. In the context of Mangaung, it is a concern that untreated water from sewage works as well as other sewage often leaks into the environment (as evidenced by numerous recent articles in local newspapers). These waters are potential carriers of large numbers of pathogens (including pathogenic yeasts/fungi) that may increase the risk to people coming into contact with it.

Baker says there is a good chance people are consuming these kinds of micro-organisms daily, considering that yeast and other filamentous fungi can also form biofilms inside pipes and spread as the impact of water flow dislodges these cells. “People will not even be aware that they are consuming these micro-organisms, some fungi are considered nuisance microbes and may cause a change in the smell and taste of water which may act as an indicator that the water is contaminated, but tests would be needed to confirm this,” she says.

The effects of consuming these fungi are still a grey area of research since the full extent of the consumption of yeast is still unknown, but there are studies being conducted to elucidate the full impact of this occurrence, says Baker. The risk depends on the immune status of the person, the specific species of yeast/fungus ingested, and the number of cells/spores ingested.

Culture-dependent and independent methods

“It is important to know that many pathogenic yeasts and other fungi are opportunistic pathogens, meaning they infect individuals whose immune systems are compromised due to various reasons such as illness (HIV/AIDS, cancer, TB etc.), undergoing organ transplants or even something as simple as using antimicrobial agents such as antibiotics.

“Taking this into account, along with the HIV/AIDS statistics in South Africa, which has a prevalence rate of 13,7% with approximately 8,2 million people in 2021 living with HIV, these individuals are more susceptible to infection by these opportunistic pathogens. Some of these pathogenic yeasts are also multidrug resistant or show resistance to readily available antifungals, such as fluconazole, which hinders the ability of healthcare professionals to efficiently treat infections to avoid fatal/severe outcomes,” explains Baker.

For her studies, she will be testing for fungi in water by using a combination of culture-dependent and independent methods to try and identify yeast present in wastewater. Baker says culture-dependent techniques will include culturing (growing) yeast on an appropriate medium while culture-independent techniques will include more intricate molecular work in the form of a multiplex PCR (polymerase chain reaction) which will enable her to identify an array of pathogenic yeasts present in samples.

According to Baker, people can stay safe by boiling water before drinking it, although temperatures above 100°C are required to kill most harmful microbes. Regular cleaning of shower heads and faucets help to prevent build-up which may act as a surface to which fungi will attach to and grow. Another way to stay safe is to maintain and regularly inspect water filters for damage and avoid contact with untreated sewage.

News Archive

Inaugural lecture: Prof Robert Bragg, Dept. of Microbial, Biochemical and Food Biotechnology

2006-05-17

Attending the inaugural lecture were in front from the left Prof Robert Bragg (lecturer at the Department of Microbial, Biochemical and Food Biotechnology) and Frederick Fourie (Rector and Vice-Chancellor). At the back from the left were Prof James du Preez (Departmental Chairperson: Department of Microbial, Biochemical and Food Biotechnology) and Prof Herman van Schalkwyk (Dean: Faculty of Natural and Agricultural Sciences). Photo: Stephen Collett

A summary of an inaugural lecture delivered by Prof Robert Bragg at the University of the Free State:

CONTROL OF INFECTIOUS AVIAN DISEASES – LESSONS FOR MAN?

Prof Robert R Bragg
Department of Microbial, Biochemical and Food Biotechnology
University of the Free State

“Many of the lessons learnt in disease control in poultry will have application on human medicine,” said Prof Robert Bragg, lecturer at the University of the Free State’s (UFS) Department of Microbial, Biochemical and Food Biotechnology during his inaugural lecture.

Prof Bragg said the development of vaccines remains the main stay of disease control in humans as well as in avian species. Disease control can not rely on vaccination alone and other disease-control options must be examined.

“With the increasing problems of antibiotic resistance, the use of disinfection and bio security are becoming more important,” he said.

“Avian influenza (AI) is an example of a disease which can spread from birds to humans. Hopefully this virus will not develop human to human transmission,” said Prof Bragg.

According to Prof Bragg, South Africa is not on the migration route of water birds, which are the main transmitters of AI. “This makes South Africa one of the countries less likely to get the disease,” he said.

If the AI virus does develop human to human transmission, it could make the 1918 flu pandemic pale into insignificance. During the 1918 flu pandemic, the virus had a mortality rate of only 3%, yet more than 50 million people died.

Although the AI virus has not developed human-to-human transmission, all human cases have been related to direct contact with infected birds. The mortality rate in humans who have contracted this virus is 67%.

“Apart from the obvious fears for the human population, this virus is a very serious poultry pathogen and can cause 100% mortality in poultry populations. Poultry meat and egg production is the staple protein source in most countries around the world. The virus is currently devastating the poultry industry world-wide,” said Prof Bragg.

Prof Bragg’s research activities on avian diseases started off with the investigation of diseases in poultry. “The average life cycle of a broiler chicken is 42 days. After this short time, they are slaughtered. As a result of the short generation time in poultry, one can observe changes in microbial populations as a result of the use of vaccines, antibiotics and disinfectants,” said Prof Bragg.

“Much of my research effort has been directed towards the control of infectious coryza in layers, which is caused by the bacterium Avibacterium paragallinarum. This disease is a type of sinusitis in the layer chickens and can cause a drop in egg product of up to 40%,” said Prof Bragg.

The vaccines used around the world in an attempt to control this disease are all inactivated vaccines. One of the most important points is the selection of the correct strains of the bacterium to use in the vaccine.

Prof Bragg established that in South Africa, there are four different serovars of the bacterium and one of these, the serovar C-3 strain, was believed to be unique to Southern Africa. He also recently discovered this serovar for the first time in Israel, thus indicating that this serovar might have a wider distribution than originally believed.

Vaccines used in this country did not contain this serovar. Prof Bragg established that the long term use of vaccines not containing the local South African strain resulted in a shift in the population distribution of the pathogen.

Prof Bragg’s research activities also include disease control in parrots and pigeons. “One of the main research projects in my group is on the disease in parrots caused by the circovirus Beak and Feather Disease virus. This virus causes serious problems in the parrot breeding industry in this country. This virus is also threatening the highly endangered and endemic Cape Parrot,” said Prof Bragg.

Prof Bragg’s research group is currently working on the development of a DNA vaccine which will assist in the control of the disease, not only in the parrot breeding industry, but also to help the highly endangered Cape Parrot in its battle for survival.

“Not all of our research efforts are directed towards infectious coryza or the Beak and Feather Disease virus. One of my Masters students is currently investigating the cell receptors involved in the binding of Newcastle Disease virus to cancerous cells and normal cells of humans. This work will also eventually lead to a possible treatment of cancer in humans and will assist with the development of a recombinant vaccine for Newcastle disease virus,” said Prof Bragg.

We are also currently investigating an “unknown” virus which causes disease problems in poultry in the Western Cape,” said Prof Bragg.

“Although disinfection has been extensively used in the poultry industry, it has only been done at the pre-placement stage. In other words, disinfectants are used before the birds are placed into the house. Once the birds are placed, all use of disinfectants stops,” said Prof Bragg.

“Disinfection and bio security can be seen as the ‘Cinderella’ of disease control in poultry. This is also true for human medicine. One just has to look at the high numbers of people who die from hospital-acquired infections to realise that disinfection is not a concept which is really clear in human health care,” said Prof Bragg.

Much research has been done in the control of diseases through vaccination and through the use of antibiotics. “These pillars of disease control are, however, starting to crumble and more effort is needed on disinfection and bio security,” said Prof Bragg.

Prof Bragg has been working in close co-operation with a chemical manufacturing company in Stellenbosch to develop a unique disinfectant which his highly effective yet not toxic to the birds.

As a result of this unique product, he has developed the continual disinfection program for use in poultry. In this program the disinfectant is used throughout the production cycle of the birds. It is also used to ensure that there is excellent pre-placement disinfection.

“The program is extensively used for the control of infectious diseases in the parrot-breeding industry in South Africa and the product has been registered in 15 countries around the world with registration in the USA in the final process,” said Prof Bragg.

“Although the problem of plasmid mediated resistance to disinfectants is starting to rear its ugly head, this has allowed for the opening of a new research field which my group will hopefully exploit in the near future,” he said.

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