Résumé
Objective: The water containing jar of the shisha water pipe is constantly moist and is a potential site for bacterial growth and biofilm formation. This study aims to examine the microbial flora and bacterial load of the water in the shisha water jar so as to determine possible risks to users
Materials and methods: Three shisha cafes participated voluntarily in the study. Seventeen de-identified water samples were collected from Shisha pipes being used by various customers at the participating Shisha Cafes. Samples were collected using sterile precautions. Ten micro L from the water samples were inoculated on a blood agar plate and incubated at 37[degree sign]C for 24 hours. The bacterial CFUs/mL were counted manually and organisms isolated were identified by Proteomic fingerprinting of ribosomal proteins using a Bruker Biotyper [Trade Mark] working on the principle of Matrix Assisted Laser Desorption Ionization- Time of Flight Mass Spectrometry, [MALDI-TOF MS]
Results: Seventeen samples were collected. Eleven samples showed microbial growth of 100 to 3000 CFUs/ml with a median value of 400 CFUs/ml. Six samples were sterile. Of the eleven samples, six samples had one organism each, two samples had two organisms each, one sample had three organisms and the last sample had five organisms. The 18 organisms isolated were distributed among nine species: Acidovorax temperans [3 isolates], Burkholderia vietnamiensis [3 isolates], Candida_pelliculosa [1 isolate], Delftia acidovorans [1 isolate], Enterobacter cloacae [3 isolates], Escherichia hermannii [1 isolate], Klebsiella pneumonia [2 isolates], Pseudomonas aeruginosa [1 isolate], and Raoultella ornithinolytica [1 isolate]. Two isolates could not be identified
Conclusions: The organisms isolated have been referenced in literature as pathogens or emerging pathogens capable of causing infections. Presence of significant amounts of pathogens in Shisha water suggests the strong possibility of inhalation of aerosols containing microbes by shisha smokers. The poly microbial nature of the isolates especially suggests the formation of bacterial biofilms. Interestingly almost all the isolates were gram negative bacteria, which contain lipopolysaccharide [LPS] in their cell walls. LPS is a microbial protein that stimulates innate immunity. LPS has been shown to be an etiological agent of acute and chronic airway obstruction and disease. Thus LPS from bacterial aerosols can contribute to the causation of COPD in chronic users, simultaneously exposing them to the risk of infection by newer emerging pathogens