Pseudomonas aeruginosa wound infection associated with a nursing home's whirlpool bath

Whirlpool baths are fitted with hydrojet circulation and/or air induction bubble systems. Water in a whirlpool bath, unlike a spa pool, is not filtered or chemically treated but the bath is drained and cleaned between each bather. This is, we believe, the first report of Pseudomonas aeruginosa wound infection associated with the use of a whirlpool bath in a nursing home. Microbiologically confirmed infections with P. aeruginosa of identical antibiotic sensitivity patterns arose in one week in wounds of four of 24 residents who used a whirlpool bath from which P. aeruginosa was also isolated. P. aeruginosa was not isolated from the wounds of a further seven residents who did not use the whirlpool bath. The incident control team advised that use of the whirlpool bath should be restricted to continent residents with intact skin, and that the bath should be cleaned with a degreasing agent and disinfected with hypochlorite between use by individual residents. The hazard of infection posed by whirlpool baths, particularly in nursing homes, needs to be assessed. National guidance for their cleaning, maintenance, and disinfection is required.