Nontuberculous mycobacteria from drinking water: beyond the lung disease epidemic

Overview

Project Summary

Water sanitation was one of the greatest health achievements of civilization as it has significantly reduced the incidence of waterborne epidemics such as cholera or typhoid. However, in the 21st century, water distribution systems continue to spread nontuberculous mycobacteria (NTM), some of which cause serious infections. Inadequate diagnostic procedures prevent an estimate of its real prevalence and epidemiological control. NTM's natural resistance to antibiotics, combined with the lack of investment in their renewal, seriously compromises our ability to fight them. Infections typically require lengthy treatments, often with severe side effects. This highlights a pressing need for prevention. NTM most commonly infects individuals with weakened immune systems or chronic diseases such as cystic fibrosis, COPD, and the elderly. It is expected that NTM disease cases will increase in some COVID-19 survivors, who may be at a much higher risk due to reported sequelae to lungs and other organs. The incidence of intestinal disorders is often associated with aged populations in developed countries and age-related chronic diseases. Additionally, the lack of NTM surveillance of drinking water and their ability to multiply in the plumbing system create conditions that aggravate a public health threat with diffuse contours. Although NTM infection is most commonly associated with the lungs, they can also interact with the intestinal mucosa. Despite the fact that this organ plays a central role in inflammation in some chronic diseases, the effctes of NTM exposure have never been addressed. This unexplored 'drinking water NTM-gut' paradigm is the focus of this project.

Main Goals

To evaluate the NTM contamination of drinking waters in Portugal, and if and how their continous interaction with the gut microbiome and mucosa, can lead to chronic diseases. This information will support public health guidelines and decisions toward NTM control.

Project Details