CHICAGO -- Bacteria-contaminated water in whirlpools, spas and hot tubs could cause urinary tract infections or fatal pneumonia, doctors said Thursday.
The infections stem from the same bacteria -- Pseudomonas aeruginosa - that cause skin rashes among whirlpool users. Bacteria buildup is due to not enough chlorine in the bath water or faulty filtering systems.
'Whirlpools, spas and hot-tubs continue to increase in popularity in homes, hotels and health clubs,' Dr. Paul Salmen of St. Joseph Hospital in Denver said in the Journal of the American Medical Association.
'Whirlpools require fastidious daily attention.'
Salmen and colleageaus reported on urinary infections found in a 25-year-old male and two girls ages 13 and 15.
'We believe these three cases to be the first reports of Pseudomonas aeruginosa urinary tract infections among previously healthy outpatients in association with a whirlpool bath or spa,' the doctors said.
All three had verified exposure to whirlpool baths within 48 hours before the onset of symptoms. The presence of the organism was confirmed at the bath sites.
'These three cases emphasize the importance of considering whirlpool bath or spa exposures as a risk factor in community-acquired urinary tract infections,' they said.
'Other factors that might enhance this risk would be sexual activity in spas and genital exposure to the water jets.'
Pseudomonas is particularly well adapted to an aquatic environment and is readily cultured from warm, moist environments such as decks, drains, seats and floors of spas.
Also in the Journal, Dr. Harold D. Rose and Medical College of Wisconsin colleagues reported whirlpool-induced pneumonia in a 45-year-old male. The man unwarily inhaled large numbers of the organism during a 90-minute bath in his contaminated whirlpool-spa.
In an editorial, Dr. Carlotta M. Rinke said sanitation standards for whirlpool tubs set by the Centers for Disease Control in Atlanta 'must be followed with renewed vigor.'
'Pseudomonas invasion of the urinary and respiratory tracts ... portends critical, potentially life-threatening illnesses,' she said, adding further research is needed to determine if the reports are 'an emerging epidemiologic phenomenon.'
