Abstract:
:Pseudomonas aeruginosa is the opportunistic pathogen mostly implicated in folliculitis and acute otitis externa in pools and hot tubs. Nevertheless, infection risks remain poorly quantified. This paper reviews disease aetiologies and bacterial skin colonization science to advance dose-response theory development. Three model forms are identified for predicting disease likelihood from pathogen density. Two are based on Furumoto & Mickey's exponential 'single-hit' model and predict infection likelihood and severity (lesions/m2), respectively. 'Third-generation', mechanistic, dose-response algorithm development is additionally scoped. The proposed formulation integrates dispersion, epidermal interaction, and follicle invasion. The review also details uncertainties needing consideration which pertain to water quality, outbreaks, exposure time, infection sites, biofilms, cerumen, environmental factors (e.g. skin saturation, hydrodynamics), and whether P. aeruginosa is endogenous or exogenous. The review's findings are used to propose a conceptual infection model and identify research priorities including pool dose-response modelling, epidermis ecology and infection likelihood-based hygiene management.
journal_name
Epidemiol Infectjournal_title
Epidemiology and infectionauthors
Roser DJ,van den Akker B,Boase S,Haas CN,Ashbolt NJ,Rice SAdoi
10.1017/S0950268813002690subject
Has Abstractpub_date
2014-03-01 00:00:00pages
449-62issue
3eissn
0950-2688issn
1469-4409pii
S0950268813002690journal_volume
142pub_type
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