Hydrotherapy: an outbreak of Pseudomonas aeruginosa wound infections related to Hubbard tank treatments

Abstract

During a 2-week period, Pseudomonas aeruginosa wound infections developed in 11 patients, 10 of whom had had hydrotherapy in Hubbard tanks before isolation of the organism from their wounds. All 10 patients had clinical evidence of disease including a temperature of greater than 100.4F, purulent wound drainage and positive culture for P. aeruginosa. These 10 patients comprised almost 60% of all patients who had received hydrotherapy during these 2 weeks. The index case had extensive cellulitis of the leg and positive wound cultures for P. aeruginosa throughout the epidemic period. Investigation revealed that the outbreak had begun coincident with the discontinuation of the use of sodium hypochlorite as a tank disinfectant and had stopped when its use had been resumed. The temporal association between the start and end of the epidemic and the use of sodium hypochlorite indicates that this agent may prevent cross-contamination and infection among patients receiving hydrotherapy.