Fungi in dialysis water and dialysate: occurrence, susceptibility to antifungal agents and biofilm production capacity

Anversa, Laís; Lara, Bruna Rossini; Romani, Caroline Demai; Saeki, Erika Kushikawa; Nascentes, Gabriel Antônio Nogueira; Bonfietti, Lucas Xavier; Melhem, Márcia de Souza Carvalho; Ruiz, Luciana da Silva; Camargo, Carlos Henrique; Richini-Pereira, Virgínia Bodelão

doi:10.2166/wh.2021.204

Cited by 4 publications

(2 citation statements)

References 55 publications

(67 reference statements)

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“…Particularly, Fusarium spp., Penicillium spp., Scedosporium spp., Rhinocladiella spp., Mucor spp., Rhinocladiella spp., Emmonsia spp., Scopulariopsis spp., Geotrichum spp., Trichoderma spp., Pithomyces spp., Phoma spp., Paecilomyces spp., and Candida spp. are reported in hospital water systems [39][40][41][42] (see Table S2 in the Supplementary Materials).…”

Section: Fungi In Water Samplesmentioning

confidence: 99%

Alternative and Classical Processes for Disinfection of Water Polluted by Fungi: A Systematic Review

Caicedo-Bejarano,

Morante-Caicedo,

Castro-Narváez

et al. 2024

Water

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The introduction of the first list of priority pathogenic fungi by the World Health Organization stresses the need to research and develop public health actions to mitigate infections caused by fungi. One of those actions involves the water disinfection systems, which comprise classical and alternative methods that have been developed in the last decades. Thereby, this work reviews the disinfection of fungi by classical methods such as chlorination, ozonation, and ultraviolet (UV) treatments and alternative advanced oxidation processes (AOPs) such as photo-Fenton, photocatalysis, or couplings of UV with peroxides. The matrices of aquatic systems (sewage, groundwater, drinking water, among others) were considered. A bibliometric analysis is performed initially, and then some aspects of the resistance to antifungals are presented, and the efficiency of the diverse processes in the reduction in fungal loading is also revised. Herein, it is shown the role of the disinfecting agents (e.g., chlorine, hydroxyl radical, or light) and their effects on fungi structures (e.g., direct DNA damage, or indirect damage due to the action of radicals). Moreover, gaps, such as the treatment of antifungal-resistant fungi and limited information about combinations among AOPs, related to the disinfection of water polluted by fungi, were identified.

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Section: Fungi In Water Samplesmentioning

confidence: 99%

Alternative and Classical Processes for Disinfection of Water Polluted by Fungi: A Systematic Review

Caicedo-Bejarano,

Morante-Caicedo,

Castro-Narváez

et al. 2024

Water

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“…Despite established guidelines, studies conducted in Brazil reveal dissatisfaction levels regarding certain parameters of water quality intended for hemodialysis, such as high levels of heterotrophic bacteria, elevated concentrations of endotoxins (Almodovar et al, 2018;Hilinski et al, 2020;de Jesus et al, 2022), and the significant presence of aluminum (de Jesus et al, 2022). Additionally, some studies report the presence of fungi in these waters, posing potential risks to the health of hemodialysis patients (Montanari et al, 2018;Oliveira et al, 2018;Anversa et al, 2021;Calumby et al, 2023).…”

Section: Introductionmentioning

confidence: 99%

Physical-chemical and microbiological characterization of water destined to hemodialysis

Gomes,

Campos,

Sant’ana

et al. 2024

Rev. ambiente água

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This research evaluated the physical-chemical and microbiological parameters of water and dialysate in four distinct hemodialysis units located in the southeast region of Brazil. The physical-chemical parameters evaluated were pH, electric conductivity, turbidity, alkalinity, free chlorine, nitrate, fluoride, chloride, sulfate, sodium, potassium, calcium, and magnesium ion concentrations. Microcystin was also quantified. The microbiological parameters evaluated were the detection of total coliform, total heterotrophic bacteria count (THB), and the isolation and identification of microorganisms in pre-reverse osmosis treatment and post-reverse osmosis treatment water samples and dialysate. The nitrate, fluoride and THB levels found in the water samples may present risk to the patient under hemodialysis treatment. Microcystin was detected in one of the potable water samples. Microorganisms were identified throughout the hemodialysis of the entire water treatment system, with Ralstonia sp. being the most frequent. The presence of emergent pathogenic bacteria highlighted in this study highlights the necessity of microbiological monitoring of water destined for hemodialysis. Keywords: dialysate, hemodialysis, water treatment.

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Fungal identification in the air and water of a hemodialysis unit in Brazil

Calumby,

Onofre-Cordeiro,

Silva

et al. 2023

Braz. J. Biol.

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The presence of fungi in healthcare settings, including hemodialysis units, represents a significant risk for immunocompromised patients. This study aimed to investigate the occurrence of fungi in the air and water of a hemodialysis unit located in a tertiary public hospital in Maceió, Alagoas, Brazil. Over a period of three consecutive months, monthly air samples were collected and analyzed using the spontaneous sedimentation technique on Petri dishes containing Sabouraud Dextrose Agar (SDA). Simultaneously, water samples (100 mL) were collected from four specific water distribution points and subjected plating on SDA. Fungi were phenotypically identified based on their macroscopic and microscopic characteristics. In total, 498 colony-forming units (CFUs) of fungi were isolated, with 86 CFUs originating from the air and 412 CFUs from the water. Regarding the water samples, a higher concentration of fungal CFUs was observed in the potable water from the supply network (229 CFUs). Unexpectedly, 23 CFUs were identified in the reverse osmosis samples and 11 CFUs in the storage tank, which are post-treatment points where the presence of microorganisms is not desired. The fungus Cladosporium spp. was the most prevalent in both air and water samples, followed by Penicillium spp. in the air and Rhodotorula spp. in the water. These findings underscore the need to implement effective control and monitoring measures for fungi in the hemodialysis unit to ensure patient safety.

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Fungi in dialysis water and dialysate: occurrence, susceptibility to antifungal agents and biofilm production capacity

Cited by 4 publications

References 55 publications

Alternative and Classical Processes for Disinfection of Water Polluted by Fungi: A Systematic Review

Alternative and Classical Processes for Disinfection of Water Polluted by Fungi: A Systematic Review

Physical-chemical and microbiological characterization of water destined to hemodialysis

Fungal identification in the air and water of a hemodialysis unit in Brazil

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