Health Research, Vol. 2, Issue 1, Mar  2018, Pages 16-23; DOI: 10.31058/ 10.31058/

Investigation of Microbiological Quality of Water from the Feed Source to the Terminal Application in the Healthcare Facility: A Case Study

Health Research, Vol. 2, Issue 1, Mar  2018, Pages 16-23.

DOI: 10.31058/

Mostafa Essam Eissa 1*

1 Microbiology and Immunology Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt

Received: 10 May 2018; Accepted: 25 May 2018; Published: 1 June 2018

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Water treatment and distribution systems are highly dynamic and versatile in terms of microbial populations. Rigorous control, maintenance and monitoring schemes should be followed to ensure delivery of water with high microbiological standards of safety from the feed sources to the final consumption points. Otherwise, consequences will be devastating to human health and possibly life itself. The current study aimed to investigate the microbiological quality in healthcare facility in urban districts region in African country using standard pharmacopeia microbiological techniques. A random samples of water from different points from feed chlorinated municipal water, water treatment plants, point-of-use and final purified water in a product with a total number of samples reaching 105 bottles of water. Isolation of microorganisms was performed using Nutrient Agar (NA), MacConkey Agar (MAC), Tryptic Soya Agar (TSA) and Muller Hinton Agar (MHA). Microbial identification of the isolates was performed biochemically. Microorganisms from seven samples were not recovered from recovery media. Two isolates from 27 specimens could not be identified using biochemical techniques and require identification using molecular methods. Eight of the final consumable products showed signs of microbial contamination with one of them could not be identified biochemically. One of the products was contaminated with two different bacteria: Escherichia coli and Staphylococcus vitulinus. Three more samples were contaminated with E. coli while S. aureus was found in one sample. Two samples were found contaminated with Pentoea spp. water stations were found to be contaminated with E. coli and S. lentus in tanks. While the reverse osmosis (RO) units were found to be contaminated with Pseudomonas luteola, Enterococcus columbae, Streptococcus uberis, E. coli and S. lentus. Water from municipal sources showed the presence of Pseudomonas luteola, Serratia ficaria, Pentoea spp, E. coli, S. aureus and S. vitulinus. The study indicated that water system control and monitoring require crucial improvements.


NA, MAC, TSA, MHA, API, VITEK2, Escherichia Coli, Staphylococcus Vitulinus, Serratia Ficaria, Pentoea Spp


© 2017 by the authors. Licensee International Technology and Science Press Limited. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


[1] Eissa, M.; Seif, M.; Fares, M. Assessment of purified water quality in pharmaceutical facility using six sigma tools. Int. J. Qual. Assur. 2015, 6(2), 54-72.

[2] Gwimbi, P. The microbial quality of drinking water in Manonyane community: Maseru District (Lesotho). Afr Health Sci. 2011, 11(3).

[3] Eissa, M. Diversity of bacteria in pharmaceutical water: Significance and impact on quality. European pharmaceutical review: Microbiol. Depth Focus, 2015, 20, 54-7.

[4] Ashour, M.S.; Mansy, M.S.; Eissa, M.E. Microbiological environmental monitoring in pharmaceutical facility. Egypt Acad J Biolog Sci. 2011, 3(1), 63-74.

[5] Bordner, R.; Winter, J.; Scarpino, P. Microbiological Methods for Monitoring the Environment: Water and Wastes. EPA-600/8-78-017, Environmental Monitoring and Support Laboratory, U.S. Environmental Protection Agency, Cincinnati, OH. 1978.

[6] USEPA. Method 1604: Total Coliforms and Escherichia coli in Water by Membrane Filtration Using a Simultaneous Detection Technique (MI Medium). 2002, 1-14.

[7] Sodium Thiosulfate - American Pool [Internet]. American Pool. Available online: (accessed 6 May 2018).

[8] General Chapters: WATER FOR PHARMACEUTICAL PURPOSES [Internet]. Available online: (accessed 6 May 2018).

[9] Clontz, L. Microbial limit and bioburden tests: validation approaches and global requirements, 2nd ed.; CRC Press: New York, USA, 2008.

[10] Eissa, M.E.; Nouby, A.S. Validation of Spore-Forming Organisms Recovery from Peroxygen-Based Disinfectants. Journal of Pharmaceutical Research & Clinical Practice, 2014, 4(2), 23-32.

[11] Özkanca, R.; Saribiyik, F.; Isik, K.; Sahin, N.; Kariptas, E.; Flint, K.P. Resuscitation and quantification of stressed Escherichia coli K12 NCTC8797 in water samples. Microbiol Res. 2009, 164(2), 212-220.

[12] OHara, C.M.; Rhoden, D.L.; Miller, J.M. Reevaluation of the API 20E identification system versus conventional biochemicals for identification of members of the family Enterobacteriaceae: a new look at an old product. J Clin Microbiol. 1992, 30(1), 123-125.

[13] Emerson, D.; Agulto, L.; Liu, H.; Liu, L. Identifying and characterizing bacteria in an era of genomics and proteomics. BioScience. 2008, 58(10), 925-936.

[14] Walterson, A.M.; Stavrinides, J. Pantoea: insights into a highly versatile and diverse genus within the Enterobacteriaceae. FEMS Microbiol Rev. 2015, 39(6), 968-84.

[15] Anahory, T.; Darbas, H.; Ongaro, O.; Jean-Pierre, H.; Mion, P. Serratia ficaria: a misidentified or unidentified rare cause of human infections in fig tree culture zones. J Clin Microbiol. 1998 Nov 1, 36(11), 3266-72.

[16] LeChevallier, M.W.; Seidler, R.J. Staphylococcus aureus in rural drinking water. Appl Environ Microbiol. 1980, 39(4), 739-42.

[17] Valentiny, C.; Dirschmid, H.; Lhotta, K. Streptococcus uberis and Staphylococcus aureus forefoot and blood stream co-infection in a haemodialysis patient: a case report. BMC nephrology. 2015, 16(1), 73.

[18] Lebreton, F.; Willems, R.J.; Gilmore, M.S. Enterococcus diversity, origins in nature, and gut colonization. Boston: Massachusetts Eye and Ear Infirmary, 2014.

[19] Yousefi, F.; Shoja, S.; Honarvar, N. Empyema Caused by Pseudomonas luteola: A Case Report. Jundishapur J Microbiol. 2014, 7(7), e10923.

[20] Bharadwaj, N.D.; Sharma, A.K. Detection of Escherichia coli, Staphylococcus aureus and Salmonella typhi in drinking water of government institutions and organizations of gwalior city. International Journal of Engineering Sciences & Research Technology. 2016, 5(7), 769-774.

[21] Neal, S. Serratia marcescens Bacteria [Internet]. Scott Neal, Eden Prairie City Manager. Available online: (accessed 6 May 2018).

[22] Eissa, M. Diversity of bacteria in pharmaceutical water: Significance and impact on quality. European pharmaceutical review: Microbiol. Depth Focus. 2015, 20, 54-7.

[23] Watkins, J.; Jian, X. In: Sutcliffe, D.W. (ed.) The microbiological quality of water. Ambleside, UK, Freshwater Biological Association. (FBA Special Publications, 5). 1997, 19-27, ISBN: 0-900386-57-6.

[24] Nowakowska, J.; Oliver, J.D. Resistance to environmental stresses by Vibrio vulnificus in the viable but nonculturable state. FEMS Microbiol Ecol. 2013, 6, 84(1), 213-22.

[25] Wood, T.K.; Knabel, S.J.; Kwan, B.W. Bacterial persister cell formation and dormancy. Appl Environ Microbiol. 2013, 1, 79(23), 7116-21.

[26] Eissa, M. Shewhart Control Chart in Microbiological Quality Control of Purified Water and its Use in Quantitative Risk Evaluation. UK Journal of Pharmaceutical Biosciences. 2016, Feb, 4(1).

[27] Eissa, M. Study of Microbial Distribution from Different Processing Stages in Purified Water Production Plant of Pharmaceutical Manufacturing Facility: Research & Reviews: Journal of Microbiology and Virology (RRJoMV). 2016, 6(1), 31-45.

[28] Sun, L. 12 superbugs that pose the greatest threat to human health [Internet]. Available online: (accessed 6 May 2018).

[29] Van Duin, D.; Paterson, D.L. Multidrug-resistant bacteria in the community: trends and lessons learned. Infectious Disease Clinics. 2016, 30(2), 377-90.

[30] Abutaleb, Y.; McNeill, R.J.; Nelson, D. The CDCs most unwanted list: superbugs that can kill [Internet]. Available online: (accessed 6 May 2018).