ArticleMicrobiome2026
Water-vapor treatment of shower systems in healthcare facilities: reshaping built-environment microbiomes to improve Legionella control and protect at-risk patients.
Article in Microbiome, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLegionnaires' disease (LD) is a severe form of pneumonia caused by inhalation of aerosols containing Legionella spp., most commonly L. pneumophila, which proliferates within protozoa embedded in established biofilms of engineered water systems, such as shower systems. Despite water management plans, durable control of L. pneumophila at terminal outlets remains challenging, partly because the effects of disinfection treatments on microbial community assembly, ecological interactions, and functional organization within biofilms are poorly understood. This study aimed to investigate how an emerging water/vapor disinfection treatment reshapes shower biofilm microbiomes at critical developmental stages - from early adhesion and biomass peak when L. pneumophila first appears, to mature biofilms associated with pathogen persistence - relative to conventional hot water disinfection, and to identify microbial taxa and functions selectively affected by these interventions.
resultsWe applied a sequential water flushing followed by high-pressure vapor (120℃) protocol either during early biofilm formation or on mature biofilms, all grown on standardized shower systems installed in healthcare, nursing home, and residential buildings subject to L. pneumophila routine control. Compared with conventional thermal disinfection of shower systems (65 °C, 10 min), water-vapor treatment more effectively removed established biofilm communities as supported by scanning electron microscopy, flow cytometry of residual cells, and culture. Amplicon sequencing of the V3-V4 region of 16S rRNA genes revealed treatment-specific shifts in microbial community composition and predicted functional profiles (R
conclusionWater-vapor treatment induces substantial ecological restructuring of shower biofilm microbiomes, affecting both taxonomic composition and functional capacity associated with biofilm resilience and pathogen persistence. These findings support that perturbation of key ecological functions within built-environment microbiomes can influence opportunistic pathogen dynamics and encourage the development of microbiome-informed strategies to complement conventional water safety management, particularly in healthcare settings. Video Abstract.
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