Pyrogenic Reactions in Hemodialysis Patients, Hanoi, Vietnam

Abstract

Of 33,111 patients admitted to a large hospital in Vietnam from November 2000 through July 2001, a total of 303 were undergoing hemodialysis and had pyrogenic reactions (ie, fever and/or rigors). Ten case patients (3.3%) had documented bacteremia; pathogens were largely waterborne microorganisms. Pyrogenic reactions in case patients might have occurred because of suboptimal water quality or inadequate dialyzer reprocessing procedures.

Microbiological quality of water and dialysate in a haemodialysis unit in Ponta Grossa-PR, Brazil

“…Endotoxaemia is probably responsible for the clinical symptoms observed in bacteraemia by Gram-negatives, causing septic shock and resulting in a high rate of mortality (Jackson et al 1994;Archibald et al 2006).…”

“…The procedure of reuse dialysers for the purpose of reducing the incidence of first use syndrome (hypersensitivity to ethylene oxide) and for economic reasons is also characterized by a problem with contamination by bacteria and endotoxins. Endotoxaemia is probably responsible for the clinical symptoms observed in bacteraemia by Gram-negatives, causing septic shock and resulting in a high rate of mortality (Jackson et al 1994;Archibald et al 2006).…”

Enumeration of heterotrophic bacteria in water for dialysis: comparison of the efficiency of Reasoner'2 agar and plate count agar

“…Microorganisms may grow very quickly in water and dialysis fluids, and the development of biofilms enables their persistence in the system, increasing the risk of contamination (3, 4, 6, 9, 10, 12, 13, 15, 16, 18, 22). The intact membrane of the dialysis machine should prevent the contamination of the blood with bacteria from the dialysis fluid.…”

“…The intact membrane of the dialysis machine should prevent the contamination of the blood with bacteria from the dialysis fluid. However, infections may still occur when membrane integrity is compromised, when microbial contamination of the water is high or when contamination occurs during the reutilization of the dialysis machines (3, 13, 14, 16, 22). …”