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#1 Hillbilly Hot Tub

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Posted 04 September 2008 - 12:33 PM

Does anyone have any knowledge about MRSA and hot tubs? Its a drug resistant staff infection, a super bacteria. I have information that things need to be sanitized, but nothing stating what sanitizes it. Being that many things are chlorine resistant now, I was wondering if our hot tub is sanitized. We just found out our son has this and we let him come over to use the tub when he had an open wound of it. We did not know it was MRSA at the time, they said it was an ingrown hair. Have I been soaking in staff or does the chlorine kill it? On top of it I have been trying a new "seaweed based" system and keeping the chlorine levels low! blink.gif Joy, Joy!
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#2 Ep7735

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Posted 04 September 2008 - 01:48 PM

QUOTE(Hillbilly Hot Tub @ Sep 4 2008, 12:33 PM) <{POST_SNAPBACK}>
Does anyone have any knowledge about MRSA and hot tubs? Its a drug resistant staff infection, a super bacteria. I have information that things need to be sanitized, but nothing stating what sanitizes it. Being that many things are chlorine resistant now, I was wondering if our hot tub is sanitized. We just found out our son has this and we let him come over to use the tub when he had an open wound of it. We did not know it was MRSA at the time, they said it was an ingrown hair. Have I been soaking in staff or does the chlorine kill it? On top of it I have been trying a new "seaweed based" system and keeping the chlorine levels low! blink.gif Joy, Joy!



oddly enough, my husband just came down with a staph infection they think is a result from an ingrown hair . all i know is that the first question the dr asked us was "has anyone entered your hot tub with a staph infection?" ...just be on the look out for any "zits". if you catch them early it can be okay. my husband is in a whole lot of pain right now... i went ahead and drained the hot tub even though i had soaked in it with him while he had staph before we knew it was staph...i just didn't want to take that chance.

#3 chem geek

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Posted 04 September 2008 - 05:28 PM

You have, of course, taken a safe approach and I would never dissuade you from doing that. Nevertheless, with proper consistent disinfection of your hot tub, you should not be overly concerned.

Chlorine kills through rather powerful and generic chemical mechanisms and is not like an antibiotic that kills through very specific and narrow mechanisms. This means that bacteria and other pathogens do not develop large resistance to chlorine since no single mutation helps them resist chlorine to any large extent (small increments are possible, but at sufficient chlorine levels even these mutants do not survive).

What you may be thinking of with regard to chlorine resistance are the protozoan cysts such as Giardia and especially Cryptosporidium. These have ALWAYS been resistant to chlorine and many other chemicals because they have a very tough outer layer (shell) for the cyst. This is something that evolved over a very long time in response to being more likely to survive in a harsh external environment and was not something developed through just a few mutations.

Some bacteria form biofilms and these are also more resistant to chemical attacks such as that from chlorine, but such biofilms do not form instantly so if the bacteria are killed quickly enough, then biofilms can be prevented from forming. This link shows, in Table 2, how free-floating bacteria are readily killed with a CT value of around 0.1 for a 99% kill, but in biofilms the CT value is closer to 1000, at least for Pseudomonas aeruginosa which is the bacteria that causes hot tub itch. Therefore, it is very important to have a disinfectant in the spa to kill the bacteria BEFORE it forms biofilms.

It is true that if you do not kill off essentially ALL of the bacteria, then what remains are more resistant strains as is described in this paper. MSRA is not a difficult bacteria to kill IN THE ENVIRONMENT (you can't use chlorine to stop an infection in a person; chlorine is non-discriminatory and will react with everything inside you so would hurt you as much if not more than the bacteria if ingested -- chlorine is NOT a drug!). It is readily killed by chlorine as quickly as other bacteria -- with CT values less than 0.1. This means that a hot tub with 4 ppm FC and 20 ppm CYA will kill 99% in less than 30 seconds. HOWEVER, if one uses Dichlor regularly and has the CYA rise to high levels, then the kill time decreases. Also, if one does not have chlorine in the water during their soak, then the bacteria can grow, though it still takes 15 minutes to an hour to double in population as with most bacteria.

The bottom line is that proper sanitation of a hot tub not letting the disinfectant get to zero or doing so only very briefly (< 1 hour) will prevent runaway bacterial growth, including MRSA. Use of metal ion systems including silver ion can help prevent bacterial growth even if the chlorine goes to zero, though it will not prevent person-to-person transmission as it does not kill as quickly as chlorine (though using silver ion in conjunction with MPS at hot tub temperatures does kill fairly quickly).

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#4 Whoneedsavacation

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Posted 05 September 2008 - 09:13 AM

MRSA is not a "normal" staph germ. Just catching it early is not sufficient, it's a resistent strain. So I'd superchlorinate/shock/whatever before getting back in. And you might want to let your M.D. know in case he or she thinks prphylactic treatment of some sort is warranted.

#5 chem geek

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Posted 05 September 2008 - 11:42 AM

QUOTE(Whoneedsavacation @ Sep 5 2008, 10:13 AM) <{POST_SNAPBACK}>
MRSA is not a "normal" staph germ. Just catching it early is not sufficient, it's a resistent strain. So I'd superchlorinate/shock/whatever before getting back in. And you might want to let your M.D. know in case he or she thinks prphylactic treatment of some sort is warranted.

As for superchlorinating, that is of course a safe thing to do, especially if there was a known exposure to MRSA. However, just to be clear, MRSA is resistant to ANTIBIOTICS, not to chlorine. This link from the CDC states:

Methicillin-resistant Staphylococcus Aureus (MRSA) is a type of staph that is resistant to certain antibiotics. These antibiotics include methicillin and other more common antibiotics such as oxacillin, penicillin and amoxicillin.


In fact, the recommended procedures for killing MRSA on surfaces include using an EPA registered sanitizer such as those from this list that includes sodium hypochlorite. For disinfection of surfaces, higher chlorine levels are used (typically 1:100 dilution of 6% bleach, so around 650 ppm FC) but that is because the contact and total exposure time are very short. There is no source anywhere I can find that indicates that MRSA takes any longer to kill with chlorine than any other bacteria (most CT values of 99% kill in the range of 0.04 to 0.08; tougher in the range 0.1 to 0.5; Francisella tularensis NY98 with 2.0). I did find this link from the CDC states the following on MRSA from a spa:

Pseudomonas is not the only bacterium that can cause spa-related skin infections. MRSA was associated with an outbreak involving an athletic spa in Connecticut (August 2003; 34). MRSA infections can have substantial consequences, as in this outbreak in which otherwise healthy young athletes were hospitalized. Factors contributing to this outbreak included the presence of skin abrasions on the athletes from "turf burns" and body shaving, and the communal use of an athletic spa that employed limited and unproven disinfection methods. Appropriate spa operation, maintenance, and cleaning should prevent outbreaks of this emerging infectious disease.


Richard

#6 Hillbilly Hot Tub

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Posted 05 September 2008 - 12:11 PM

Thanks to all. Talked to Doc today, we have to watch for "pimples" and fever since we have all ready soaked in our tub the last 2 weeks unknowing that he had MRSA. I was most worried because we keep the risidual down to 1 or 2, but with the ozone and MPS shocking and if this "Natural" sea weed stuff is working, we should be ok.

Our son on the other hand is not well, just got the call while typing, he is being rushed to the hospital, fever spiked to 107 so got to go.....
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#7 Whoneedsavacation

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Posted 05 September 2008 - 02:57 PM

QUOTE(chem geek @ Sep 5 2008, 12:42 PM) <{POST_SNAPBACK}>
As for superchlorinating, that is of course a safe thing to do, especially if there was a known exposure to MRSA. However, just to be clear, MRSA is resistant to ANTIBIOTICS, not to chlorine.


Right. I just meant it's nothing to mess with. I'd take it very seriously.

HHT, best wishes for your son!

#8 chem geek

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Posted 05 September 2008 - 04:39 PM

QUOTE(Whoneedsavacation @ Sep 5 2008, 03:57 PM) <{POST_SNAPBACK}>
HHT, best wishes for your son!

Hillbilly Hot Tub,

Ditto from me. I hope your son recovers soon.

Richard

#9 Hillbilly Hot Tub

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Posted 06 September 2008 - 08:48 AM

Thanks All. At this time he is in ICU at the hospital but things are looking better. They think because he was not treated correctly a month ago that the MRSA got into his blood stream. They started by treating him for an infected ingrown hair.

They just found out his wife has contacted it from him, but they caught it early and tehy are also treating our 3 year old grandson topically for it. This is nasty stuff, has spa itch looking like a bug bite! We will see what the weekend brings to us.
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#10 Hillbilly Hot Tub

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Posted 08 September 2008 - 01:17 PM

Hes still in the hospital. His fever has not quite broken yet. He has to go 24 hours fever free before he can come home.

Giving him a trade in hot tub we got so he can have his own. No more visitors in mine! biggrin.gif The poor kid has gone through hell!
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#11 chem geek

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Posted 11 September 2008 - 07:08 AM

Any updates? How is your son doing?

#12 Whoneedsavacation

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Posted 11 September 2008 - 02:01 PM

Yes, let us know. I was wondering, too.

#13 Hillbilly Hot Tub

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Posted 12 September 2008 - 07:03 AM

He stayed in ICU untill Tuesday and then they sent him home that night. 5 days in ICU but he is doing much better. He actually went back to work all ready.

His wife is doing well with her treatment and our grandson seems to have missed getting it although they are treating him with a special body wash and antibiotic for his bug bites and scratches. They had to sanitize their house, all sheets, towels, clean couches chairs ect. It was great fun.

As a note, I have learned there have been cases of MRSA spread via hot tubs. These tubs had no records on what/how they were maintained and were heavy use tubs. Lesson learned here is not to let your EPA approved sanitizer drop to low because you never know!
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#14 waterbear

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Posted 10 July 2009 - 08:45 AM

QUOTE (Hillbilly Hot Tub @ Sep 12 2008, 11:03 AM) <{POST_SNAPBACK}>
Lesson learned here is not to let your EPA approved sanitizer drop to low because you never know!

I believe I have said this once or twice! (or was it in the hundreds and thousands?)
wink.gif
I've tested more water than I ever care to think about!
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#15 bart6453

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Posted 10 July 2009 - 09:58 AM

QUOTE (Hillbilly Hot Tub @ Sep 12 2008, 10:03 AM) <{POST_SNAPBACK}>
As a note, I have learned there have been cases of MRSA spread via hot tubs. These tubs had no records on what/how they were maintained and were heavy use tubs. Lesson learned here is not to let your EPA approved sanitizer drop to low because you never know!


WOW...NO KIDDING. Friends don't let Friends use dirty hot tubs!

Thank God you are a responsible hot tub owner.....I have seen some nasty tubs...and I never get in...and this is why.....can you imagine if you hadn't been fastidious about the sanitizer?

No more skipping days of checking the tub for me.....(not that I do it that often anyways)

glad everyone is doing well.
It's gonna be okay....trust me!

#16 Nitro

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Posted 13 July 2009 - 03:29 PM

Just imagine if you were using a sanitation method that doesn't kill bacteria very well, "Peroxysan" (i.e. Hydogen Peroxide). This poster is trying to convince you to do just that.
Nitro's Approach To Water Maintenance
A guide to Water Balance and Sanitation using Chlorine

Lowering Total Alkalinity
How to lower TA, without lowering pH

Chlorine Demand (CD)
What is it, and why you should care

Decontamination
How to Super Shock your Tub

#17 bart6453

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Posted 13 July 2009 - 04:37 PM

QUOTE (Nitro @ Jul 13 2009, 06:29 PM) <{POST_SNAPBACK}>
Just imagine if you were using a sanitation method that doesn't kill bacteria very well, "Peroxysan" (i.e. Hydogen Peroxide). This poster is trying to convince you to do just that.


I have a buddy that has been using 35% peroxide in his pool....been trying to convince him not to.

I think this thread finally has him convinced it's a bad call.

Needless to say....I don't swim in his pool.
It's gonna be okay....trust me!

#18 Hillbilly Hot Tub

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Posted 17 July 2009 - 10:29 AM

We won't even get into what kind of damage peroxide does to equipment.........

Its been a year since the MRSA, our poor son has been struggling with all kinds of things, he has Crone's which causes his resistance to be low, this was probabley the reason for catching MRSA so severely, and because of ongoing open wounds he has, he does not use the tub for his saftly (even though we keep our sanitizer level good!!) and for our saftey.

Getting ready to go on vacation where there are several pools and hot tubs, will be bringing my test kit with me! Don't care if they think I am a nutter or not!
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#19 chem geek

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Posted 22 September 2009 - 06:56 AM

Yes, the protozoan oocysts developed their tough shell over continued exposure to a harsh environment over an extended period of time, and that harsh environment didn't include chlorine. That was the point -- that chlorine wasn't going to have pathogens develop immunity, at least not quickly the same way that happens with antibiotics.




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