<b>Detection of microorganisms, endotoxins and aluminum in mobile dialysis services

Abstract

ABSTRACT. Hemodialysis water and dialysates are fundamental in the treatment of kidney disease. During just one hemodialysis session, 120 liters of dialysate are consumed. Thus, it is essential that the parameters of chemical and microbiological quality of the fluids used in dialysis systems are carefully observed. In this study, water samples were collected at 12 hospitals in the state of Rio de Janeiro. The samples were obtained at three points of fluid reservoirs: pre-, post-osmosis and dialysis solution. After collection, colony forming units (CFU), total coliforms and Escherichia coli 100 mL -1 were quantified. Later, isolated colonies and endotoxin content were identified by biochemical assays. Data about total aluminum levels per sample (mg L -1 ) were also obtained. Samples of all mobile dialysis services and points of collection were contaminated above the levels set out by national laws, in particular by Pseudomonas aeruginosa. Endotoxin levels were also above the recommended by current legislation (> 0.25 EU mL -1 ). Only three samples contained detectable levels of aluminum, which were found to be above the recommended values for the corresponding resolution (0.01 mg L -1 ). Finally, there were no observable amounts of total coliforms and E. coli 100 mL -1 sample. The data from this study are an important step forward in the standardization and control of chemical/microbiological quality of mobile dialysis services.Keywords: dialysis, hemodialysis units, dialysis solutions.Detecção de microrganismos, endotoxinas e alumínio em serviços de diálise móvel RESUMO. Águas de hemodiálise e dialisatos são peças fundamentais na terapêutica da doença renal. Durante apenas uma sessão de hemodiálise, são consumidos aproximadamente 120 litros de dialisato. Desta forma, é essencial que os parâmetros de qualidade microbiológica e química dos fluidos utilizados em sistemas de diálise sejam cuidadosamente observados. Neste trabalho, foram coletadas amostras de água em 12 hospitais do Estado do Rio de Janeiro. Amostras foram obtidas em pontos pré-osmose, pós-osmose e solução de diálise. Após coleção, quantificaram-se unidades formadoras de colônias (UFC), coliformes totais e Escherichia coli 100 mL ). Por fim, não foram encontradas quantidades observáveis de coliformes totais e E. coli 100 mL -1 de amostra. Dados de nosso estudo são importante avanço na padronização e controle de qualidade química/microbiológica em serviços de diálise móvel.Palavras-chave: diálise, unidades hospitalares de hemodiálise, soluções para diálise.

Physical-chemical and microbiological characterization of water destined to hemodialysis

“…Also, de Jesus et al (2022) studying hemodialysis units in Rio de Janeiro, Brazil, employing biochemical methods for bacterial identification, corroborated the findings of Anversa et al (2022). It is noteworthy that the common presence of the species Pseudomonas aeruginosa, widely documented in various Brazilian studies using biochemical techniques (Lima et al, 2005;Borges et al, 2007;de Jesus, et al, 2017;; MALDI-TOF (Anversa et al, 2022); and molecular biology identification methods (Montanari et al, 2009), was not detected in the present investigation.…”

“…Most of the bacteria species that were isolated belong to the nonfermenting gramnegative category, with the exception of Serratia marcescens, which is part of the fermenting gram-negative group. The gram-negative bacteria, especially the nonfermenting ones, are the most common microbiological contaminant found in hemodialysis water (Chen et al, 2017;de Jesus, et al, 2017;Anversa et al, 2022;Chaoui et al, 2022). In the study conducted by Anversa et al (2022) in hemodialysis units in São Paulo, Brazil, MALDI-TOF methodology was employed, resembling the approach used in the present research.…”

Monitoring the quality of the water used in mobile dialysis services in intensive care units in the city of Rio de Janeiro

“…samples collected in 36 hospitals in the city of rio de janeiro in mobile dialysis services in 2017 and 2018. 23 .…”

“…Among the microorganisms surveyed, the species most often found was Pseudomonas aeruginosa, followed by Escherichia coli, Stenotrophomonas maltophilia, Ralstonia pickettii and Burkholderia cepacia, and to a lesser extent Pseudomonas stutzeri, Acinetobacter anitratus, Acinetobacter baumannii, Acinetobacter calcoaceticos sp. lowffii, Sphingomonas paucimobilis, Brevundimonas diminuta, Moraxella osloensis, Moraxella lacunata, Moraxella henylpyruvia, Moraxella atlantae, Achronobacter xylosoxidans , which are commonly found in water samples 23 .…”