Opportunistic premise plumbing pathogens (OPPPs) in the built environment: transmission, resistance, and strategies for detection and mitigation

Healthcare associated infections (HAIs) lead to tens of thousands of deaths annually, with 21.6 % being caused by water, according to Collier S, Deng L, Adam E, Benedict K, Beshearse E, Blackstock A, et al. Estimate of burden and direct healthcare cost of infectious waterborne disease in the United States. Emerging Infect Disease J 2021;27:140. This is partially due to Opportunistic Premise Plumbing Pathogens (OPPPs); which may exhibit resistance to disinfection and thrive in pipe biofilms. Evidence found in literature indicates the rate of infections caused by OPPPs are going to increase with time, highlighting the need for better understanding of their detection and mitigation. The aim of this review is to provide insight on the latest status of OPPP research and highlight areas that need further investigation. It also emphasizes the importance of proactive surveillance, extensive water management protocols, and advanced detection technologies in reducing waterborne healthcare-associated infections. Ultimately, it was found there is still extensive research needed to fully mitigate and prevent pathogenic outbreaks.