The microbiological quality of water in fish spas with Garra rufa fish, the Netherlands, October to November 2012.

In fish spas, clients may submerge their hands, feet or whole body in basins with Garra rufa fish, for dead skin removal. Skin infections may result from using these spas, transmitted from fish to clients, through either fish or water, or from client to client. The microbiological water quality was determined in 24 fish spas in 16 companies in the Netherlands through analysis of a single water sample per fish spa. Water samples were tested for the presence of Aeromonas spp., Vibrio spp.,Pseudomonas aeruginosa, nontuberculous mycobacteria,and faecal indicator bacteria by using standard culture methods. The majority of the examined fish spas contained Aeromonas spp. (n = 24), P. aeruginosa(n = 18), Vibrio spp. (n = 16) including V. cholerae non-O1/O139 and V. vulnificus, and several rapid growing Mycobacterium spp. (n = 23) including M. fortuitum, M.conceptionense, M. abscessus and M. chelonae. Faecal contamination of the fish spa water was low. Based on the detected concentrations of Aeromonas spp., Vibriospp., and P. aeruginosa, the detected Mycobacteriumspp., and the health implications of these bacteria, the health risk from using fish spas is considered limited for healthy people with an intact skin and no underlying disease.