Evaluation and control of microbial and chemical contamination in dialysis water plants of Italian nephrology wards
| Autor: | Serena Giorgi, Angelo Baggiani, Pietro Luigi Lopalco, Paola Valentini, Gaetano Pierpaolo Privitera, Mario Miccoli, Michele Totaro, Beatrice Casini, Andrea Davide Porretta |
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| Rok vydání: | 2017 |
| Předmět: |
Microbiology (medical)
Nephrology medicine.medical_specialty endotoxins Hospital Departments 030232 urology & nephrology Burkholderia cepacia Dialysis patients Water Purification Toxicology reverse osmosis 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Microbial risk Renal Dialysis Water Supply Internal medicine Aquatic plant medicine Humans Peracetic Acid 030212 general & internal medicine Intensive care medicine Societies Medical Cross Infection business.industry Dialysis fluid Drinking Water General Medicine dialysis water microbial contamination Contamination Hemodialysis Solutions Disinfection Infectious Diseases Italy chemistry Sodium hypochlorite Practice Guidelines as Topic Pseudomonas aeruginosa Water Microbiology business Dialysis (biochemistry) |
| Zdroj: | Journal of Hospital Infection. 97:169-174 |
| ISSN: | 0195-6701 |
| Popis: | Summary Background Patients receiving haemodialysis are exposed to a large volume of dialysis fluid. The Italian Society of Nephrology (ISN) has published guidelines and microbial quality standards on dialysis water (DW) and solutions to ensure patient safety. Aim To identify microbial and chemical hazards, and evaluate the quality of disinfection treatment in DW plants. Methods In 2015 and 2016, water networks and DW plants (closed loop and online monitors) of nine dialysis wards of Italian hospitals, hosting 162 dialysis beds overall, were sampled on a monthly basis to determine the parameters provided by ISN guidelines. Chlorinated drinking water was desalinated by reverse osmosis and distributed to the closed loop which feeds all online monitors. Disinfection with peracetic acid was performed in all DW plants on a monthly basis. Findings Over the 24-month study period, seven out of nine DW plants (78%) recorded negative results for all investigated parameters. Closed loop contamination with Burkholderia cepacia was detected in a DW plant from January 2015 to March 2015. Pseudomonas aeruginosa was isolated from March 2016 to May 2016 in the closed loop of another DW plant. These microbial contaminations were eradicated by shock disinfection with sodium hypochlorite and peracetic acid, followed by water flushing. Conclusion These results highlight the importance of chemical and physical methods of DW disinfection. The maintenance of control measures in water plants hosted in dialysis wards ensures a microbial risk reduction for all dialysis patients. |
| Databáze: | OpenAIRE |
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