Children’s ball pits full of pathogenic microbes

By Sally Robertson, B.Sc.Mar 25 2019Reviewed by Kate Anderton, B.Sc. (Editor)

A new study has found that the ball pits used by children in physical therapy clinics may be colonized with various microorganisms, some of which are linked to blood infections, sepsis and meningitis.

Dasha Muller | Shutterstock

Researchers at the University of North Georgia found significant microbial colonization in ball pits located across six clinical settings, nine of which were opportunistic pathogens.

The popularity of ball pits has increased since the 1980s when the fun pools were introduced into restaurant chains nationwide. As well as the dirt, feces, vomit or urine that is sometimes visible in the pits, numerous bacterial species have been found including normal human skin bacteria and opportunistic pathogens such as Staphylococcus aureus.

Ball pits are also commonly used in physical therapy clinics to provide stimulation for children with sensory processing disorders or motor impairments. However, national standards or protocols for cleaning these enclosures remain elusive, say study authors Dobrusia Bialonska and colleagues.

Accordingly, clinics may go days or even weeks between cleanings, which may allow time for microorganisms to accumulate and grow to levels capable of transmission and infection.”

They also note that the risk of infection is increased, should a child already have skin lesions or abrasions.

As recently reported in the American Journal of Infection Control, the researchers swabbed between nine and 15 balls taken from ball pits located in six Georgia community clinics and identified the microorganisms present.

The team found that bacterial colonization was found to be as high as thousands of cells per ball, thereby demonstrating the risk of transmission and possibly infection amongst exposed children.

Among the microbes identified were 31 species of bacteria and one species of yeast. Nine of the microorganisms were opportunistic pathogens, including eight pathogenic bacteria and one pathogenic yeast.

Among the human-associated bacteria identified were Enterococcus faecalis, which is known to cause septicemia, meningitis, and urinary tract infections; Staphylococcus homini which can cause bloodstream infections and Streptococcus oralis, which is known to cause infective endocarditis and streptococcal shock.

The team also found considerable variability in the number of colonizing forming units between different clinics and locations, suggesting that clinics use different cleaning and maintenance protocols.

Further study of the amount of colonisation should be performed... and, if warranted, standardised cleaning protocols developed to limit the presence of opportunistic pathogens in this environment.”