Is your hot water hot enough?

There's an interesting paper in the March issue of Emerging Infectious Diseases that examines water cultures from homes of patients with nontuberculous mycobacterial infections (full text here). This paper caught my eye because it's our perception at VCU that we're seeing more patients with pulmonary atypical mycobacterial infections. Curiously, we rarely see Legionella, another waterborne pathogen.

In this study, water samples were obtained from 31 NTM-infected patients' homes from across the US. 59% of the homes had NTMs found in the water, and 46% had matching species. Of note, patients whose hot water temperature was <125° were two-fold more likely to have contaminated water than those whose water was >130°. The author recommends that patients at risk of NTM infections (slender elderly persons and cystic fibrosis heterozygotes), crank up the heat on their hot water tanks.