title: Incidence of Pseudomonas aeruginosa in recreational and hydrotherapy pools.
abstract: Pseudomonas aeruginosa remains an important agent of opportunistic infection in patients, particularly those with respiratory complications and burns. One natural niche of this organism is water and water-associated facilities, hence the aim of this study was to examine specimens from recreational and hydrotherapy pools in Northern Ireland over a two-year period. Water specimens (n = 3,510) were obtained from three amenity categories, namely, 13 hydrotherapy pools (specimen number [n] = 323), 51 Jacuzzis/spas (n = 1,397) and 68 swimming pools (n = 1,790). Specimens (100 ml) were filtered through a cellulose acetate (0.45 micron pore size) gridded filter and the membrane was placed on Pseudomonas CFC agar (Oxoid CM559 + SR103) and incubated at 37 degrees C for 48 +/- 2 h. Colonies that clearly showed pyocyanin production or met other identification criteria were considered P. aeruginosa. Of the amenities examined 4/13 hydrotherapy pools (30.8%), 37/51 Jacuzzis/spas (72.5%) and 26/68 swimming pools (38.2%) were positive for P. aeruginosa. The most heavily contaminated amenity category was the Jacuzzi/spa, where 34.7% and 12% of private and public sites respectively were positive for P. aeruginosa at a level of greater than 1,000 cfu 100 ml-1. Approximately twice as many samples were positive in private Jacuzzis/spas compared to publicly operated facilities. There was a similar trend with respect to public and private hydrotherapy pools, though bacterial counts did not exceed 1,000 cfu 100 ml-1. Recreational and therapeutic amenities involving the use of water may be a potential source of P. aeruginosa for susceptible patient groups, including patients with cystic fibrosis and bronchiectasis. This may vary depending on amenity type and public/private ownership of such amenities.
authors.affiliation: Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, Belfast BT9 7AD. jemoore@niphl.dnet.co.uk
authors.forename: J E
authors.initials: JE
authors.lastname: Moore
authors.forename: N
authors.initials: N
authors.lastname: Heaney
authors.forename: B C
authors.initials: BC
authors.lastname: Millar
authors.forename: M
authors.initials: M
authors.lastname: Crowe
authors.forename: J S
authors.initials: JS
authors.lastname: Elborn
mesh_terms: D006801:Humans; D006875:Hydrotherapy / Q000009:adverse effects*; D015994:Incidence; D007494:Ireland / Q000453:epidemiology; D011552:Pseudomonas Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D011998:Recreation; D012307:Risk Factors; D013551:Swimming Pools / Q000592:standards; D014871:Water Microbiology / Q000592:standards*; D014881:Water Supply