Microbial contamination of dialysate and its prevention in haemodialysis units

Microbiological contamination of a hemodialysis center water distribution system

“…This result gives cause for concern, in view of the well-known resistance to biocides and antibiotics shown by bacteria of this genus, which is often cited as the causative agent in reports of septicemia and endotoxemia 3,18,27 .…”

“…OIE et al 27 showed that dialysis solutions are most frequently contaminated with heterotrophic bacteria, P. aeruginosa and fungi. The present investigation indicates that P. aeruginosa represented 24.0% of the bacteria isolated, a result very similar to the 22.7% found by ARVANITIDOU et al 6 .…”

“…The formation of biofilms, which promote the persistence of bacteria at various points in the system and protect them form disinfection, increases the risk of contamination and raises the levels of endotoxins in the water 25 . OIE et al 27 have suggested that dialysis solution is especially prone to be contaminated in this way and they recommended placing an ultra-filtration membrane at the entrance of the dialyser, to stop any contaminant in the dialysis solution from gaining entrance.…”

“…1). In such a system, the tubes, tanks and taps represent potential reservoirs for microorganisms that contribute to biofilms which, once formed, are extremely hard to eradicate by chemical or mechanical means 9,27,34 . Some studies reported the presence of biofilm in the tubing carrying hemodialysis fluids and noted its high resistance to biocides.…”

Detection Method for Aquatic Bacteria of the Fingers, as a Potential Origin of the Aqueous Solution Contamination

“…Previously, we reported that the incidence of dialysate contamination increased, as shown by an increase in endotoxin value, when maintenance of the central dialysate delivery system CDDS was performed without hand hygiene Honda et al 2010 . In DNA sequencing analysis of skin microbes, independent of culture method, the main bacteria of the hands have been reported to be Gramnegative aquatic bacteria, such as Proteobacteria Fierer et al 2008, Grice et al 2009, Kong 2011 , which have been shown to be able to contaminate dialysate Oie et al 2003 . However, when bacteria from the hands were isolated and cultured, microbes from the phylum Firmicutes, such as coagulase-negative staphylococci CNS , predominate despite using a medium suitable for aquatic bacterial culture Cook 2007 . We attempted to isolate the aquatic bacteria inhabiting the hands by bacterial culture to demonstrate that hand hygiene associated with contamination of waterbased materials, such as dialysate.…”