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Samples were analyzed for total coliforms,\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      , heterotrophic bacteria (HB), bacterial isolation and identification, antimicrobial susceptibility testing, and ERIC-PCR genotyping was applied to\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      isolates to analyse their similarity with clinical isolates. Statistical analysis used the chi-square test of independence (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Despite legal compliance for coliforms, elevated HB counts were found in 17% of water tank samples and 12% of ICU samples. Pathogens such as\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      ,\n                      <jats:italic>Stenotrophomonas maltophilia<\/jats:italic>\n                      , and\n                      <jats:italic>Enterobacter<\/jats:italic>\n                      spp. were isolated.\n                      <jats:italic>Enterobacter<\/jats:italic>\n                      spp. isolates exhibited resistance to multiple \u03b2-lactams. Genotypic analysis did not reveal a direct clonal relationship between\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      isolates from water and NDM-producing\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      isolates recovered from hospitalized patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Although the hospital water distribution system complied with current microbiological potability standards, opportunistic bacteria were detected in localized areas of the network. The absence of clonal relatedness between environmental and clinical\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      isolates suggests that the water system was not an active source of dissemination during the study period. These findings support the value of routine environmental surveillance as part of infection prevention strategies within a One Health framework.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s42770-026-02078-5","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T08:10:37Z","timestamp":1788509437000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["One Health in hospital settings: the role of water as an invisible reservoir of opportunistic pathogens"],"prefix":"10.1007","volume":"57","author":[{"given":"Emilly Brito","family":"Ferreira","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Lopes","family":"da Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica de Souza Ferreira de","family":"Mattos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilton Vizi","family":"Martinez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo Jorge","family":"Pilau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Cristina Bronharo","family":"Tognim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabr\u00edcia","family":"Gimenes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Machinski Junior","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben\u00edcio Alves","family":"de Abreu Filho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"2078_CR1","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms11071794","author":"C Farina","year":"2023","unstructured":"Farina C, Cacciabue E, Averara F, Ferri N, Vailati F, Castilho GD et al (2023) Water safety plan, monochloramine disinfection and extensive environmental sampling effectively control Legionella and other waterborne pathogens in nosocomial settings: The ten-year experience of an italian hospital. 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