Reducing Exposure to Nontuberculous Mycobacteria (NTM)

Posted by Armando @bolso1, Sep 16, 2021

Please see the attached document prepared by Dr. Joseph O. Falkinham, III, a world authority on the management of NTM dispersion.

Shared files

Reducing Exposure to Nontuberculous Mycobacteria (Reducing-Exposure-to-Nontuberculous-Mycobacteria.pdf)

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

@sueinmn

When water is distilled, the purpose is to remove metals and other contaminants; doing that actually sterilizes the water. The bottling and sealing process may or may not be done in sterile conditions.

Distilled water used in medical settings is bottled in sterile conditions, labelled sterile, and provided in ampules, bags or bottles of appropriate size to be completely used in one application. Leftover amounts are not considered sterile and are discarded (for example, a squeeze bottle used for wound irrigation is tossed after the wound is bandaged.)

When distilled water is bottled for commercial use (like the gallon jugs in the grocery store) they are not labelled sterile, so the bottling process is unknown. And once the bottle is opened, airborne contaminants can find their way into the bottle, so it can no longer be considered sterile. If the seal is compromised during handling, it may or may not be sterile when you buy it. That said, distilled water is nutrient-poor, so it is a poor growing medium for bacteria, but…

I don't use any sinus rinse, but if I did, I would err on the side of caution and boil whichever water I use according to their instructions.

As for Crystal Geyser being the recommended spring water, I believe it is a matter of personal taste and availability. Have you found something different?

Sue

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My respirologist said that even distilled water needs to be boiled for 10 minutes for a sinus rinse.

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Can anyone suggest an Electric Kettle that allows you to boil water for 10 minutes? Most of the ones I have looked at have an automatic shut off after the water is boiled.

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@kathyhg

My respirologist said that even distilled water needs to be boiled for 10 minutes for a sinus rinse.

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@kathyhg Thanks for the confirmation.
@pop55 Wow, you are right – the best I could find was one where you could set it to 212F and use the keep warm to hold it there. People have been asking about one with no shutoff on line for at least 8 years. Apparently it was done to reduce fire risk from kettles that boiled try.
Sue

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I just used a stainless steel kettle on the stove to boil water for 10 minutes.

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@pop55

Can anyone suggest an Electric Kettle that allows you to boil water for 10 minutes? Most of the ones I have looked at have an automatic shut off after the water is boiled.

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I am also interested. My kettle shuts off too.

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@pop55

Can anyone suggest an Electric Kettle that allows you to boil water for 10 minutes? Most of the ones I have looked at have an automatic shut off after the water is boiled.

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@pop55
A portable water heater?

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@sueinmn

@kathyhg Thanks for the confirmation.
@pop55 Wow, you are right – the best I could find was one where you could set it to 212F and use the keep warm to hold it there. People have been asking about one with no shutoff on line for at least 8 years. Apparently it was done to reduce fire risk from kettles that boiled try.
Sue

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What about an instant hot water dispenser? I think the water can be kept at 140-200 degrees, mine produces up to 60 cups near boiling water per hour. Do you think the water would have mycobacteria?

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@pop55

What about an instant hot water dispenser? I think the water can be kept at 140-200 degrees, mine produces up to 60 cups near boiling water per hour. Do you think the water would have mycobacteria?

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Here is my layperson's take on this question.
According to a couple publications (which I cannot seem to copy right now) MAC & MAI are killed by 5 seconds of exposure to temperatures of 70C (about 170F). At that temperature, formation of any biofilm to harbor bacteria would be very limited. It would seem this would limit the amount of mycobacteria in the water.

Other considerations would be the frequency and cost of filter replacement, and how to clean the tank regularly.

This is neither a scientific opinion, nor a recommendation, simply some things to consider. If you are considering it, more research into the safety and a discussion with your pulmonologist would be warranted.

Sue

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@sueinmn

Thank you Armando.
I did note this article references the one I had seen earlier about "pink slime" mold and NTM not being able to coexist – I wonder why I couldn't find it earlier this year when I was searching?
Also, for those concerned about drinking water while travelling – it appears we have 2 viable options – bottled Spring Water (vs purified drinking water) and the commercially available filtering water bottle. I'm heading out for an appointment, but will look up the availability when I get home.
Sue

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Based on Falkinham's article I also purchased a SteriPen on Amazon which is a UV water purifier. I will use this in the future for my Neti pot while traveling. Also would be great for drinking water. Nancy

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@sueinmn

Here is my layperson's take on this question.
According to a couple publications (which I cannot seem to copy right now) MAC & MAI are killed by 5 seconds of exposure to temperatures of 70C (about 170F). At that temperature, formation of any biofilm to harbor bacteria would be very limited. It would seem this would limit the amount of mycobacteria in the water.

Other considerations would be the frequency and cost of filter replacement, and how to clean the tank regularly.

This is neither a scientific opinion, nor a recommendation, simply some things to consider. If you are considering it, more research into the safety and a discussion with your pulmonologist would be warranted.

Sue

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Thanks Sue, I appreciate your time and information! This unit is about $150. and they don't have filters and there is no way to clean them.

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