| | Aeromonas: Human Healh Criteria Document |
| | 0,95 | | MB |
| | 198 | | stron |
| | 5447 | | ID | UNITED STATES ENVIRONMENTAL PROTECTION AGENCY |
| | 2006 | | rok |
| | Contents |
| | Disclaimer v |
| | Foreword vi |
| | Acknowledgements vii |
| | External Peer Review Workgroup viii |
| | 1 0 Executive Summary 1 |
| | 1 1 General Information 1 |
| | 1 2 Occurrence 2 |
| | 1 3 Health Effects in Humans 2 |
| | 1 4 Health Effects in Animals 5 |
| | 1 5 Risk Assessment 5 |
| | 1 6 Methods 6 |
| | 1 7 Water Treatment 7 |
| | 1 8 Indicators of Occurrence and Treatability7 |
| | 2 0 General Information 8 |
| | 2 1 History 8 |
| | 2 2 Taxonomy 11 |
| | 2 3 Description of the Genus 15 |
| | 2 4 Methods19 |
| | Isolation and Enumeration from Environmental Samples 23 |
| | 2 4 2 Isolation from Clinical Specimens 24 |
| | 2 4 3 Culture Identification Methods 25 |
| | 2 4 4 Molecular Detection Methods 29 |
| | 2 4 5 Typing Methods 32 |
| | 2 5 Summary 34 |
| | 3 0 Occurrence 35 |
| | 3 1 Worldwide Occurrence 36 |
| | 3 1 1 Occurrence in Human Population 36 |
| | 3 1 2 Occurrence in Animal Population 38 |
| | 3 1 3 Occurrence in Water 41 |
| | 3 1 4 Occurrence in Food 46 |
| | 3 1 5 Occurrence in Other Media48 |
| | 3 2 Environmental Factors Affecting Survival48 |
| | 3 2 1 Survival in Water 49 |
| | 3 2 2 Survival in Food 51 |
| | 3 2 3 Viable but Non-culturable State 53 |
| | 3 2 4 Preservation in Stock Cultures 54 |
| | 3 3 Summary 54 |
| | 4 0 Health Effect in Humans 55 |
| | 4 1 Clinical Symptoms 56 |
| | 4 1 1 Mechanism of Virulence 56 |
| | 4 1 1 1 Cell-Associated Virulence Factors 59 |
| | 4 1 1 2 Extracellular Virulence Factors 66 |
| | 4 1 1 3 Type II Secretion Systems 76 |
| | 4 1 1 4 Type III Secretion Systems 76 |
| | 4 1 1 5 Siderophores 77 |
| | 4 1 1 6 Quorum Sensing 78 |
| | 4 1 1 7 Opsonins 78 |
| | 4 1 1 8 Glycosylation 78 |
| | 4 1 1 9 Suicide Phenomenon 79 |
| | 4 1 1 10 Vacuolation 79 |
| | 4 1 1 11 Pathogenicity Islands 79 |
| | 4 1 2 Gastrointestinal Infection 80 |
| | 4 1 3 Skin and Soft Tissue Infection 83 |
| | 4 1 4 Respiratory Tract Infections 86 |
| | 4 1 5 Meningitis 87 |
| | 4 1 6 Endocarditis 87 |
| | 4 1 7 Osteomyelitis 87 |
| | 4 1 8 Hepatobiliary Infections 87 |
| | 4 1 9 Bacteremia/Septicemia 88 |
| | 4 1 10 Peritonitis 88 |
| | 4 1 11 Hemorrhagic Uremic Syndrome 89 |
| | 4 1 12 Ocular Infections 89 |
| | 4 1 13 Septic Arthritis 90 |
| | 4 2 Predisposing Factors 90 |
| | 4 3 Chronic Conditions/Sequelae 90 |
| | 4 4 Dose Response 91 |
| | 4 5 Immunity/Vaccines 91 |
| | 4 6 Therapeutic Measures 91 |
| | 4 6 1 Antibiotic Treatment 92 |
| | 4 6 2 Other Therapeutic Strategies 95 |
| | 4 7 Sensitive Sub-populations 95 |
| | 4 7 1 Elderly 95 |
| | 4 7 2 Children 96 |
| | 4 7 3 Immunocompromised 97 |
| | 4 8 Summary 99 |
| | 5 0 Health Effect in Animals 100 |
| | 5 1 Clinical Symptoms 101 |
| | 5 1 1 Mechanism of Action/Disease 101 |
| | 5 1 2 Chronic Conditions/Sequelae 101 |
| | 5 2 Dose Response 102 |
| | 5 3 Immunity/Vaccines 102 |
| | 5 4 Therapeutic Measures 102 |
| | 5 4 1 Antibiotic Treatment 102 |
| | 5 4 2 Other Therapeutic Measures 102 |
| | 5 5 Sensitive Subpopulations 103 |
| | 5 6 Summary 103 |
| | 6 0 Epidemiology and Disease Outbreaks 103 |
| | 6 1 Transmission Routes and Mechanisms 103 |
| | 6 1 1 Foodborne Transmission 103 |
| | 6 1 2 Waterborne Transmission 104 |
| | 6 1 3 Person-to-person Transmission 105 |
| | 6 1 4 Animal-to-person Transmission 105 |
| | 6 1 5 Environmental Transmission 105 |
| | 6 2 Disease Outbreaks 106 |
| | 6 2 1 Outbreaks Associated with Drinking Water 106 |
| | 6 2 2 Outbreaks Associated with Recreational Water 107 |
| | 6 2 3 Outbreaks Associated with Other Water Sources 107 |
| | 6 2 4 Food 107 |
| | 6 2 5 Travelers 109 |
| | 6 2 6 Other Sources 109 |
| | 6 3 Summary 109 |
| | 7 0 Risk Assessment 110 |
| | 7 1 Risk Assessment Paradigms/Models 112 |
| | 7 1 1 Assessment of Virulence Factors as an Indication of Risk 112 |
| | 7 1 1 1 Studies Characterizing Virulence Markers in Clinical and Environmental Isolates 113 |
| | 7 1 1 2 Studies Characterizing Virulence Markers in Clinical Isolates 115 |
| | 7 1 1 3 Studies Characterizing Virulence Markers in Environmental Isolates 117 |
| | 7 1 1 4 Studies Characterizing Virulence Markers in Food Isolates 119 |
| | 7 1 1 5 Studies Characterizing Virulence Markers in Animal Isolates 123 |
| | 7 2 Risk Assessment Case-Control Studies 123 |
| | 7 2 1 Laboratory Studies 123 |
| | 7 2 2 Studies in Younger Children 124 |
| | 7 2 3 Field Studies 125 |
| | 7 2 4 Animal Studies 125 |
| | 7 2 5 Typing Studies 126 |
| | 7 3 Risk Factors 126 |
| | 7 4 Potential for Human Exposure 127 |
| | 7 5 Risk Management 127 |
| | 7 6 Summary 128 |
| | 8 0 Water Treatment 129 |
| | 8 1 Conventional Water and Wastewater Treatment 130 |
| | 8 1 1 Slow Sand Filtration 130 |
| | 8 1 2 Activated Sludge Plant/Trickling Filter Plant 131 |
| | 8 1 3 Treatment Plants and Distribution Systems 131 |
| | 8 1 4 Rapid Gravity Filters 132 |
| | 8 2 Disinfection/Inactivation 132 |
| | 8 2 1 Disinfection 134 |
| | 8 2 2 Inactivation 135 |
| | 8 2 3 Distribution Systems 135 |
| | 8 2 4 Survival 136 |
| | 8 3 Summary 137 |
| | 9 0 Indicators for Occurrence and Treatability 137 |
| | 9 1 Relationship of Aeromonads to Other Microbial Indicators 138 |
| | 9 2 Summary 138 |
| | 10 0 References 139 |