Whirlpool baths in nursing homes: use, maintenance, and contamination with Pseudomonas aeruginosa

Transmission of Pseudomonas aeruginosa wound infection was associated with the use of a whirlpool bath in a nursing home. The nursing home inspection unit asked for guidance on whirlpool baths in nursing homes and advice for proprietors about their use, cleaning, disinfection, and maintenance. Seventeen whirlpool baths in 16 nursing homes in two health districts were examined for the presence of P. aeruginosa. A survey was made of the use made of whirlpool baths, methods used to clean and disinfect them, and the occurrence of P. aeruginosa wound infection in users. P. aeruginosa were found in large numbers in water samples from all whirlpool baths after agitation. Only one of the 253 residents who used whirlpool baths was known to have a P. aeruginosa wound infection. The local nursing home inspection unit was advised that whirlpool baths could continue to be used in nursing homes but only by continent residents with intact skin. The bath should be cleaned and disinfected, preferably with hypochlorite, after each use; the bath should be more thoroughly cleaned and disinfected daily and the bath should be fully serviced at least once a year. Suspected or confirmed cases of P. aeruginosa infection in residents of nursing homes should be reported to the consultant in communicable disease control. The prevalence of known infection with P. aeruginosa was low in the residents of the nursing homes, but the unguided and unregulated use of whirlpool baths in nursing homes may present an infection hazard to residents who use the bath and to hospitals that admit residents from such nursing homes.(ABSTRACT TRUNCATED AT 250 WORDS)