title: [Monitoring and control of opportunistic bacteria in a spa water used for aerosol hydrotherapy].
abstract: A bicarbonate-sulphate-calcic water of a therapeutic spa was monitored for the presence of Legionella, Pseudomonas and Mycobacteria. The water was analysed by taking samples from the well, the feed tank and from the final aerosol generating devices of two different water lines, the former at 21-23 degrees, the second at 36-38 degrees. The bacteria in question were always absent from the well. Legionellae were found in the water of aerosol equipment: Legionella micdadei was isolated from 75% of samples, L. bozemanii from 75% and 50% (respectively 36-38 degrees and 21-22 degrees water lines) and other species of environmental Legionellae from 25% of samples. The water of aerosol equipment presented high total bacterial counts (10(3)-10(4) cfu/ml) and exspecially high concentrations of Pseudomonadaceae (10(2)-10(3) cfu/100 ml). These bacteria, unlike the Legionellae, were also isolated from the feed tank at mean concentrations of about 10(2) cfu/100 ml. Mycobacteria were found in 75 and 50% of samples collected from final devices, respectively from the heated and not heated water lines. The isolates were M. gordonae (85% of isolates) and M. fortuitum (15%), but at concentrations very low. Both treatments with sodium hypochlorite (20 ppm of residual chlorine) and peracetic acid (20 ppm) resulted in the reduction of total bacterial counts and elimination of Pseudomonas from the water in the tank, but not in elimination of Pseudomonas and Legionellae from the nebulizers. The disinfectants were evidently not able to efficiently reach all the points where Pseudomonas and Legionella had settled and grown. In order to obtain total abatement it was necessary to carry out a radical restructuring of the plant, involving the replacement of the old nebulizer benches with new aerosol equipment that could be subjected to a new system of programmed thermal shock.
authors.affiliation: Dipartimento di Medicina e Sanità Pubblica, Sezione di Igiene, Università degli Studi di Bologna.
authors.forename: E
authors.initials: E
authors.lastname: Leoni
authors.forename: F
authors.initials: F
authors.lastname: Zanetti
authors.forename: S
authors.initials: S
authors.lastname: Cristino
authors.forename: P P
authors.initials: PP
authors.lastname: Legnani
mesh_terms: D000336:Aerosols; D001431:Bacteriological Techniques; D006294:Health Resorts; D006801:Humans; D006875:Hydrotherapy; D007558:Italy; D007875:Legionella / Q000302:isolation & purification*; D009161:Mycobacterium / Q000302:isolation & purification*; D011549:Pseudomonas / Q000302:isolation & purification*; D014871:Water Microbiology / Q000592:standards
chemical_list: D000336:Aerosols