Researchers found microbial colonization of balls located in pediatric physical therapy ball pits, according to a study published in the American Journal of Infection Control.
Mary Ellen Oesterle, EdD, PT, the department head of the physical therapy department in the College of Health Sciences and Professions at the University of North Georgia, and colleagues wrote that the popularity of ball pits has increased since some restaurant chains installed them in the 1980s. They wrote that the recreational pits are often contaminated “with visible dirt, vomit, feces or urine,” which provides an environment for microbial contamination.
Opportunistic pathogens such as Staphylococcus aureus and various enteric bacteria have been identified in the ball pits.
Ball pits are used in pediatric physical therapy to provide stimulation for children with sensory and motor impairments. With a lack of national cleaning standards, the researchers wrote that the clinics can go weeks at a time between cleaning the ball pit areas, “which may allow time for microorganisms to accumulate and grow to levels capable of transmission and infection.”
Oesterle and colleagues examined six ball pits in therapy clinics in Georgia, where they randomly selected and sampled nine to 15 balls from different depths of each ball pit.
“We found considerable variation in the number of microorganisms between the different ball pit samples,” Oesterle said in a press release from the Association for Professionals in Infection Control and Epidemiology (APIC). “This suggests that clinics utilize different protocols for cleaning and maintenance, potentially presenting a broader need to clarify and establish standards that reduce the risk of transmission.”
Oesterle and colleagues identified 31 bacterial species and one species of yeast among the microorganisms isolated from the ball pits. The human-associated bacteria included Enterococcus faecalis, which can cause endocarditis, septicemia, UTIs and meningitis; Staphylococcus hominis, which can cause bloodstream infections and was reported as a cause of sepsis in a neonatal ICU; Streptococcus oralis, which can cause endocarditis, adult respiratory distress syndrome and streptococcal shock; and Acinetobacter lwofii, which has been reported to cause septicemia, pneumonia, meningitis, urinary tract and skin infections, the researchers wrote.
“The research shows that ball pits may pose an infection hazard,” 2019 APIC president Karen Hoffman, RN, MS, CIC, said in the release. “Facilities should establish a program for regular cleaning to protect patients and health care workers from potential infection risks.” – by Bruce Thiel
Disclosures: The authors report no relevant financial disclosures.