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Dental care unit waterlines (DCUWs) consist of complex networks of thin tubes that facilitate the formation of microbial biofilms. Due to the predilection toward a wet environment, strong adhesion, biofilm formation, and resistance to biocides,Pseudomonas aeruginosa , a major human opportunistic pathogen, is adapted to DCUW colonization. Other nonfermentative Gram-negative bacilli, such as members of the genusAchromobacter , are emerging pathogens found in water networks. We reported the 6.5-year dynamics of bacterial contamination of waterlines in a dental health care center with 61 dental care units (DCUs) connected to the same water supply system. The conditions allowed the selection and the emergence of clones ofAchromobacter sp. andP. aeruginosa characterized by multilocus sequence typing, multiplex repetitive elements-based PCR, and restriction fragment length polymorphism in pulsed-field gel electrophoresis, biofilm formation, and antimicrobial susceptibility. One clone ofP. aeruginosa and 2 clones ofAchromobacter sp. colonized successively all of the DCUWs: the last colonization byP. aeruginosa ST309 led to the closing of the dental care center. Successive dominance of species and clones was linked to biocide treatments.Achromobacter strains were weak biofilm producers compared toP. aeruginosa ST309, but the coculture ofP. aeruginosa andAchromobacter enhancedP. aeruginosa ST309 biofilm formation. Intraclonal genomic microevolution was observed in the isolates ofP. aeruginosa ST309 collected chronologically and inAchromobacter sp. clone A. The contamination control was achieved by a complete reorganization of the dental health care center by removing the connecting tubes between DCUs.

Pseudomonas aeruginosa and Achromobacter sp. Clonal Selection Leads to Successive Waves of Contamination of Water in Dental Care Units