The Bacterial Biofilms in Dialysis Water Systems and the Effect of the Sub Inhibitory Concentrations of Chlorine on Them

Abstract

Introduction: The presence of bacteria in the form of biofilms poses a problem in the fluid pathways of haemodialysis plants and procedures which are aimed to detach and neutralize biofilms are necessary to improve the patient safety and the quality of the healthcare.The present study was therefore aimed at isolating the organisms which colonized dialysis water systems as biofilms, as well as to study the effect of the sub inhibitory concentrations of chlorine on the biofilms which were produced by these isolates.Methods: Swabs were used to collect the biofilms which were produced on the internal surface of the dialysis tubing from the dialysis units. This study was conducted at the Department of Microbiology, Kasturba Medical College (KMC), Mangalore, India. The cultures were performed on MacConkey's agar and blood agar. The organisms which were isolated were identified and antibiotic sensitivity tests were performed. The biofilm production was done by the microtitre plate method of O'Toole and Kolter. The biofilm production was also studied in the presence of sub inhibitory concentrations of chlorine.Results: Acinetobacter spp and Pseudomonas aeruginosa were the two predominant organisms which colonized the dialysis water systems as biofilms. The sub inhibitory concentrations of chlorine did not bring about any decrease in the biofilm production by the isolates. On the contrary, there was an increase in the biofilm production. Conclusion:Our study highlighted the importance of using appropriate methods to improve the quality of the water in dialysis units. This in turn, may help in reducing the biofilm formation in the water systems of dialysis units and thus, contribute to the prevention of hospital acquired infections in the patients who need haemodialysis.

Is dialysis water a safe component for hemodialysis treatment in São Paulo State, Brazil?

“…In general, microbial contamination is associated with deficiencies in the production and/or inadequate maintenance of the water treatment and distribution system. Bacterial growth in water purification system is influenced by several factors, such as the chemical composition, design of distribution pipes, flow rate, pressure and the temperature of the feed water (Roth, Jarvis, 2000;Coulliette;Arduino, 2013;Suman et al, 2013).…”

Home hemodialysis: Infrastructure, water, and machines in the home

“…Regular heat disinfection of the water distribution system is recommended to prevent the formation of biofilm. Prevention is better than cure, Disinfection with hypochlorous acid/hypochlorite or bleach has been shown to be inadequate for disinfection of fluid pathways to remove biofilm, Frequent heat disinfection. Maintenance Regular maintenance and cleaning processes should be scheduled to prevent contamination of the water pathways within the equipment. Heat disinfections can help prevent the formation of biofilm, but hard‐to‐reach areas within water equipment need to be manually cleaned.…”

“…Regular heat disinfection of the water distribution system is recommended to prevent the formation of biofilm. Prevention is better than cure, Disinfection with hypochlorous acid/hypochlorite or bleach has been shown to be inadequate for disinfection of fluid pathways to remove biofilm, Frequent heat disinfection. …”

“…Disinfection with hypochlorous acid/hypochlorite or bleach has been shown to be inadequate for disinfection of fluid pathways to remove biofilm,…”

Isolated Bacteria from Hemodialysis Water Distribution Systems in Hemodialysis Centers in Bandung

“…4 The most predominant isolated bacteria were Pseudomonas aeruginosa and Acinetobacter species. 5 There is no data found exist, however, regarding bacterial contamination in hemodialysis water distribution systems in Indonesia. Thus, it is important to explore the possibility of contamination of the hemodialysis water distribution systems in hemodialysis centers located in Bandung.…”