Journal article
The plumbing problem: rising antimicrobial resistance in building water systems
Current opinion in infectious diseases, Vol.38(4)
06/06/2025
PMID: 40471045
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Abstract
This review examines the interplay between biological and anthropogenic factors in the development and persistence of antimicrobial resistance (AMR) within building plumbing systems, which is of particular concern in high risk setting such as healthcare facilities. The review highlights the role of biofilms and amoeba as reservoirs for AMR and explores how engineering and design decisions, governance structures, and cleaning protocols influence microbial resistance dynamics.
Recent findings: Biofilms provide a protective environment that facilitates horizontal gene transfer and enhances bacterial resistance to disinfection. Amoeba-hosted bacteria can evade standard cleaning practices, further promoting AMR persistence. Emerging technologies, such as digital twin modelling, offer new opportunities to optimize risk mitigation strategies. However, more consideration is needed to be given to design or management decision that may have unintended consequences, such as unintended design outcomes, such as increased biofilm growth from tap mixers and low-flow fixtures, and ineffective cleaning protocols, which can inadvertently worsen AMR.
Summary: Effectively managing AMR in plumbing systems requires a multidisciplinary approach that integrates microbiology, engineering, and policy. Data driven risk assessments can identify high-risk areas that may require design changes but also can enable targeted cleaning strategies, reducing reliance on widespread disinfection that may drive resistance. Future policies must consider system-wide implications to prevent unintended consequences. By addressing both biological and anthropogenic drivers, we can develop sustainable solutions to mitigate AMR risks in healthcare and beyond.
Details
- Title
- The plumbing problem: rising antimicrobial resistance in building water systems
- Creators
- Claire Hayward - University of South AustraliaHarriet Whiley - Flinders UniversityNicholas J Ashbolt - University of South Australia
- Publication Details
- Current opinion in infectious diseases, Vol.38(4)
- Publisher
- Wolters Kluwer Health, Inc.
- Identifiers
- 991013288848602368
- Copyright
- Copyright © 2025, Copyright © 2025 The Author(s).
- Academic Unit
- Faculty of Science and Engineering
- Language
- English
- Resource Type
- Journal article