ArticleProceedings of the National Academy of Sciences of the United States of America2009
Opportunistic pathogens enriched in showerhead biofilms.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 214 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
214 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Transmission of COVID-19 and other infectious diseases in public washrooms: A systematic review.The Science of the total environment · 2022Pooled it
- Guideline
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- Long-term influences of pipe materials on bacterial communities of matured biofilms (> 40 years' old) in drinking water distribution systems.Fundamental research · 2026Article
- Review
- Review
- Spinal infections.Frontiers in neuroscience · 2026Review
- Pathogenicity and virulence ofVirulence · 2025Review
- Intracellular glutamine fluctuates with nitrogen availability and regulatesJournal of bacteriology · 2025Article
- Temperature-dependent microbial dynamics in touchless sensor faucets during short-term stagnation.Environmental science and ecotechnology · 2025Article
- The growing impact of nontuberculous mycobacteria: A multidisciplinary review of ecology, pathogenesis, diagnosis, and treatment.Infectious medicine · 2025Review
- Culture and real-time quantitative PCR to detect environmental nontuberculous mycobacteria in a clinical care center.Total environment microbiology · 2025Article
- Moving Beyond the Silos of Opportunistic Pathogen and Disinfection Byproduct Research to Improve Drinking Water System Management.Environmental science & technology · 2025Review
- Ten questions concerning water quality in building hot water systems.Building and environment · 2025Article
- Genomic Epidemiology of Mycobacterium abscessus on the Island of Montréal Is Not Suggestive of Health Care-Associated Person-to-Person Transmission.The Journal of infectious diseases · 2025Article
- The Advance and Clinical Practice on Lung Disease Caused byInfection and drug resistance · 2025Article
- Growth in biofilms preparesFrontiers in microbiology · 2025Article
- Microbial drinking water quality deterioration during distribution and household usage, determined together with citizen scientists.PloS one · 2025Article
- Flavin and deazaflavin biosynthesis in mycobacteria: relevance to physiology, implications for drug discovery, MR-1 antigenicity, and vaccine development.Frontiers in immunology · 2025Review
- Microbial Colonization, Biofilm Formation, and Malodour of Washing Machine Surfaces and Fabrics and the Evolution of Detergents in Response to Consumer Demands and Environmental Concerns.Antibiotics (Basel, Switzerland) · 2024Review
154 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The environments we humans encounter daily are sources of exposure to diverse microbial communities, some of potential concern to human health. In this study, we used culture-independent technology to investigate the microbial composition of biofilms inside showerheads as ecological assemblages in the human indoor environment. Showers are an important interface for human interaction with microbes through inhalation of aerosols, and showerhead waters have been implicated in disease. Although opportunistic pathogens commonly are cultured from shower facilities, there is little knowledge of either their prevalence or the nature of other microorganisms that may be delivered during shower usage. To determine the composition of showerhead biofilms and waters, we analyzed rRNA gene sequences from 45 showerhead sites around the United States. We find that variable and complex, but specific, microbial assemblages occur inside showerheads. Particularly striking was the finding that sequences representative of non-tuberculous mycobacteria (NTM) and other opportunistic human pathogens are enriched to high levels in many showerhead biofilms, >100-fold above background water contents. We conclude that showerheads may present a significant potential exposure to aerosolized microbes, including documented opportunistic pathogens. The health risk associated with showerhead microbiota needs investigation in persons with compromised immune or pulmonary systems.
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