The science nerd here again –
While I agree that it is prudent to avoid vectors of infection, I still find the research on the issue of NTM in showers to be inconclusive as to whether there is high risk of infection there.
While the study cited, https://www.pnas.org/content/106/38/16393.long, was somewhat alarming regarding the widespread incidence of NTM in shower heads, I found this paragraph especially interesting:
"…Showerhead biofilms and water are potential sources of aerosolized microorganisms. However, different microbes and biofilms have different qualities that can influence partitioning into aerosols. Indeed, we and others have shown that mycobacteria can be selectively aerosolized, possibly a consequence of their waxy, hydrophobic quality (3, 25). To determine the makeup of shower aerosol microbiology, we collected aerosols during 20-min unoccupied shower operations with three showerheads analyzed rRNA gene sequences and compared them with biofilm, water, and ambient bathroom air samples. Microbial constituents were reflective of feedwaters and not biofilm. It seems possible, however, that any initial pulse of biofilm components would have been extensively diluted by water delivered during the aerosol collection period, and so not detected…"
In other words, the very characteristic that makes NTM difficult to eradicate, the waxy biofilm, may also make it less likely to aerosolize in the shower.
While the study goes on to conclude that showers may be a vector of infection, the paragraph above doesn't support the specific conclusion, in my opinion. Instead, I think the conclusion "…We conclude that there is need for further epidemiological investigations of potential sources of NTM infections, including showerheads. The methods we use here provide an experimental approach for such investigations…" is much more important.
My takeaway from all of this is to exercise caution, minimize exposure to the initial blast of hot, steamy water from any shower head, and continue to my healthy life precautions. For those who are seriously concerned about water-borne infection, I would say shower head replacement or disinfection is one of those reasonable precautions.
Also, I find it very interesting that NTM are far less prevalent in well water – makes me happy that for half the year, that is my water source!

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@sueinmn
That's good you have well water 1/2 the time anyway. I guess Mac isn't inhibited by all the chlorine in the city water supply much at all.
Are you in Minnesota thought maybe from your title sueinmm?
I'm in St Paul Minnesota.

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@migizii I’m in Bemidji, MN and perhaps you doctor at Mayo in Rochester, too? I have not entered the shower head discussion as I am not convinced it to be anymore of a problem than anything else we run into in our life. We need to be careful, but I don’t want to be overly concerned. I checked with my pulmonologist and he wasn’t worried about hot tubs as long as they are cleaned regularly, so he thought that means excluding going in people’s home hot tubs as they are less likely to be cleaned as often as commercial settings. My recent scan showed indications of NTM infection but since I rarely produce sputum, I have to start wearing one of those vests and then he is going to order new sputum tests after there is some mucus production.

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Here is a article that just came out today. It quotes top microbiologist Joseph Falkingham.
https://www.insideedition.com/could-your-showerhead-be-making-you-sick-what-inside-edition-found-52543

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Hi all:
I received my Shower Clear and it is a very high quality heavy brass shower head that flips open to dry after use. I got mine for 235.00 with a discount code. Its a little spendy but the quality is there and I will never need to replace this shower head. Happy that it completely dries between uses. I've had pseudomonas and aspergillus mold also in my lungs and feel it (may) help prevent these infections also.
The owner told me there is a hospital that using his Shower head now primarily. There is also a study on Mac in shower heads being conducted and they are including his Shower head in the study. It will be interesting to hear the results!

Shari
https://www-shopshowerclear-com.myshopify.com/

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I ordered the Shower Clear shower head. I have not installed it yet. Has anybody had problems with how heavy how it is?

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I ordered the Shower Clear shower head. I have not installed it yet. Has anybody had problems with how heavy how it is?

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If it makes you feel better that you are "doing something" by replacing your shower head, then do it. But that doesn't help with exposure to MAC prevalent throughout the environment.
After reading everything I can get my hands on, I would say the science isn't there yet to prove a conclusive link between your MAC infection and specifically, your shower. And even less that replacement of the shower head will "cure" the problem or prevent reinfection. As I understand this disease, once your lungs are colonized with MAC, it is not totally eradicated by treatment – just knocked down to undetectable numbers, so trying to "prevent infection" may be a moot point.
All of the studies cited are of very limited scope, with small sample sizes, and only one (from Japan) compared strains of mycobacterium found to the strains infecting residents of the homes. The results showed that only a few of the NTM found in the showers matched the strain the patient was infected with. None of the studies went as far as to evaluate any treatments like disinfecting or replacing the shower heads.
From a microbiological perspective, the biofilm that is formed surrounding NTM is tough, and I don't know what you can do at home to dislodge it & disinfect. That should certainly be subjected to thorough study as part of NTM research. That biofilm readily attaches to plastic – hmm, maybe the increase in infection is linked not to the shower heads, but to the replacement of copper plumbing and metal fixtures with plastic fixtures and pipe (PVC & PEX.) That would certainly be something to study as well.
As for myself, I have chosen to take the path of living a normal life, with reasonable precautions. I eat, rest, exercise, take my meds and do my breathing treatments to stay healthy. I wash my hands (a lot) and keep them away from my face. I avoid close contact with sick people. That means taking care when handling soil (avoid dust, wear gloves, wash thoroughly afterward.) At my Texas home, where I am pretty sure I contracted MAC, I have covered all the soil near my patio with ground cover, have a gardener mow, weed, rake & fertilize my yard & wash the patio while I am away & the house is well closed. I only garden there in pots with sterile potting soil. And I avoid blowing dust.

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@sueinmn Late reply. "once your lungs are colonized with MAC, it is not totally eradicated by treatment – just knocked down to undetectable numbers". Interesting. I've read quite a few studies but haven't seen this. I am going to look further into it. I agree with just living life and not worrying about the source of MAC/NTM. It is everywhere in the environment and my specialist said I would need to live in a bubble in order to avoid it. I've been off meds and MAC free (or perhaps MAC undetectable?) for over 2 years so far!

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Please share your findings on this! I’ve just finished my first 3 months on medication. When I started, I thought that the medication would “cure” the mac. I’ve learned a lot since then and now hopeful that the the treatment gets it to undetectable numbers.

Question – how do the specialists figure out when that is? CT? Bronchoscopy? And I thought you stay on the meds for a period of time even after it’s eradicated?

Tomorrow is my first follow up appointment with my respirologist but I would like to go prepared :).
Thanks.

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@kathyhg Are you on the 'Big 3' meds? If so, three months is not long enough,. You would need to be on them for 12 to 18 months ( according to mac specialists). They will probably do a sputem test on you at this appointment (they should anyway) Please read all that you can about mac if you have not already. Good sources for info are http://www.ntminfo.org and http://www.njh.org and http://www.nih.gov. @janovr said she tested negative for mac after only 3 months on the big 3. So…….

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Thanks. I am on them and I know it’s not long enough. Sadly. But I’m still curious how they can tell if 15 months is enough. Or 18 months? I thought that there was a period after which the Mac is cleared that you still have to be on the meds? Or does it actually take 15-18 months to clear it? Obviously I need to do more reading myself!
Thanks.

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