Pedicure Infections: How they happen and how to spot and avoid them. part 2

The (Bacterium) Culprits

One usual culprit in pedicure infections is Mycobacterium fortuitum, a non-tuberculous mycobacterium. This bacterium is known to cause boils that resemble insect bites that eventually enlarge to produce pus. These boils can last a very long time and some never really heal until treated with antibiotics. Some victims can have but just one ulcer or lesion while others can have dozens! They all normally ooze pus.

Numerous outbreaks of this bacterium have been reported over the years. Mycobacterium fortuitum has been found in sewage, dirt and in low levels in water sources both processed and natural. So it is very easy to get this bacterium into the inner workings of a pedicure foot spa or plumbed pedicure sink, but the key is to not let it build up to very high levels. This bacterium thrives extremely well in the organic debris that can amass at certain points in a foot spa like the filters and water screens. Fortunately, this bacterium is rarely life threatening but can leave unsightly scars when the boils and lesions finally heal.

Another very serious culprit in pedicure infections is MSRA or Methicillin-resistant Staphylococcus aureus. This bacterium is extremely difficult to treat in humans since it is very resilient to antibiotics including the penicillins and as the name suggests namely Methicillin and oxacillin. This bacterium has normally cause outbreaks in hospitals and health care settings since it’s so hard to treat and very easy to transmit from patient to patient (HA-MSRA or Health Care Associated MSRA). Recently though, it has been found causing outbreaks outside of hospitals and clinics and in communities amongst healthier people like in salons and spas (CA-MSRA or Community Associated MSRA).

MSRA can be carried around by human hosts without the host showing signs of infection. About one third of the population is usually carrying around a strain of staph bacteria, which is usually harmless until it enters the body. Even upon entering the body staph sometimes only causes minor skin problems in the healthy; sometimes though it develops into more. The usual carriage spots are the nostrils, opened wounds, the respiratory tract and urinary tract.

This is why it’s very important for people, especially when giving pedicures, to thoroughly clean their hands after doing such things as using the bathroom, blowing their noses, sneezing or coughing. If you follow what mom taught you about good hygiene, you would already be doing this though. MRSA can even survive on garments and fabrics.

Usual symptoms of infection include, small red bumps that resemble insect (spider) bites or even boils that are accompanied by fever and sometimes rashes. In only a matter of days, the boils grow into painful, deep pus filled boils. Sometimes these can turn into abscesses that require drainage by incision.

Some breakouts, about 75%, only involve the soft tissue and the skin, but other infections can get more serious. Some cases of MRSA can spread to joints, bones, wounds, vital organs and also lead to sepsis, where the entire body becomes inflamed due to infection. Sepsis is commonly called blood poisoning. Although rare it also can cause toxic shock syndrome and even flesh eating (necrotizing) pneumonia.

The real puzzling part of the problem for researchers is the fact that some people can develop very treatable MRSA skin infections while others can have infections that are widespread and lead to death where all patients are infected with the same strain of MRSA and all appear to be healthy.

It was believed that for MRSA infection to occur there needed to be a break in the skin, but new data suggests that for some strains this is not the case and MRSA can be contagious in certain situations.

There have been cases of pedicure infections from MRSA that have resulted in the amputation of limbs due to the ineffectiveness of antibiotics and in some cases death.

People with low immune systems such as diabetics, the elderly and HIV patients are especially vulnerable to bacteria pedicure infections and more serious complications including death. It is necessary for these persons to be extra vigilant in avoiding the use of non-disinfected foot spas and  pedicure sinks. If you notice any boils that won’t heal and begin to ooze pus after receiving a foot soak in a foot spa, it’s best to consult a doctor.

Disinfect!

Regular cleaning is just not enough to avoid pedicure infections as serious germs can withstand ordinary cleaners. To avoid harmful bacteria from building to high levels, disinfection is necessary. To kill harmful bacteria, viruses and fungus, the cleaning agent used must an EPA registered hospital or medical grade bactericide, viricide and fungicide. That is, an agent capable of destroying bacteria, viruses and fungus. If your cleaner is not labeled as such, then you are not thoroughly cleaning your foot spas and pedicure sinks.
                     
Some products out there are combination cleaners and disinfectants. These are probably the best products to use to avoid pedicure infections as they both clean and disinfect in one step. Some usually come in a concentrated from that can be diluted with water. It is necessary, when using disinfectants that they be allowed time to fully do their work. Ten minutes is normally the recommended length of time but be sure to read all labels on how to effectively use the product you choose. To properly clean foot spas this mixture should be run through the inner workings before each use. It would be a good idea to disinfect both before and after, if using the unit for the last time for the day.

What else to take not of?

Any type of pedicure tub or foot spa that circulates water can potentially become a breeding ground for harmful bacteria and at high risk of causing pedicure infections. Since the water has to be passed through tubing and passageways, every inch of this journey leaves possible spots for bacteria to deposit and develop. To recommend that it is necessary to avoid use of these types of units altogether might be extreme as the bacteria is usually only extremely harmful when allowed to build to very high levels.

The best thing to do is to never use a foot spa that you have not disinfected thoroughly yourself or one that you are not totally convinced has been thoroughly disinfected.

If you’re letting someone else perform your pedicure, before placing your feet into a foot spa be sure to inquire about the last time the unit has been disinfected. Foot spas should always be cleaned in between users/customers.

Don’t be afraid to ask that a foot spa and/or instruments being used be disinfected in the front of you and that you can see the agent being used to disinfect them. Be sure to look for the bactericide, viricide and fungicide indications on the label. It is even acceptable to carry your own instruments to the salon to be used on your feet. This way you are totally sure that the equipment being used is clean and has been disinfected.

Also look for registration and licensing information on the walls as well as board of health certifications. This can give patrons a false sense of security though, as many of these same salons with such certificates hanging on the walls have claimed to be just too busy to clean pedicure sinks and foot spas in between clients. Remember too, that in this digital age many documents can be forged or produced.

If the place just looks dirty and badly kept and the pedicure sinks and foot spas look "grimey", it may be better to just leave and go someplace else or perform your pedicure yourself using our definitive pedicure guide. Remember to wash your hands thoroughly before beginning though.

I reiterate, if you have any broken skin, nicks or scrapes, wait at least 24 hours before soaking in a foot spa just to be safe.

Many “busy” spas, pedicurists and individuals may slip up on the disinfecting procedures, but this step should never be skimped on. It could lead to very serious life threatening pedicure infections! Truly though, how busy can you be to willingly endanger the lives of your patrons or even yourself?

Be vigilant, be clean and disinfect to avoid serious pedicure infections!