Microbiological quality of water for hemodialysis and dialysates

Abstract

Bolesnici liječeni ponavljanim hemodijalizama izloženi su tjedno količini od oko 400-500 litara dijalizata, koji nastaje miješanjem vode za hemodijalizu s dijaliznim koncentratom. Od krvi bolesnika dijeli ga samo polupropusna membrana. Zbog toga mora zadovoljavati i stroge standarde mikrobiološke kvalitete. U ovom radu, uz iznošenje vlastitih rezultata, govori se o mikrobiološkoj kvaliteti vode za hemodijalizu i dijalizata, njenom određivanju, utjecaju na zdravlje i kontroli, uz napomenu da su infekcije, nakon kardiovaskularnih bolesti, najčešći uzrok smrti ove skupine bolesnika. Obradom redovitih mikrobioloških analiza, rađenih tijekom 6-mjesečnog razdoblja, nađeno je da, uz redovite dezinfekcije središnjeg uređaja za pripremu vode za hemodijalizu i aparata za hemodijalizu, 10% uzoraka vode za hemodijalizu i 21,43% uzoraka dijalizata ne zadovoljava AAMI standarde. Osim Pseudomonas speciesa nisu identificirane druge bakterijske vrste. U razdoblju promatranja nije bilo pirogenih reakcija. U zaključku autori ističu da značajan postotak uzoraka vode za hemodijalizu i dijalizata nije u skladu s preporučenim standardima. Unatoč tome dobiveni rezultati ne odstupaju značajno od rezultata drugih istraživača.Chronic hemodialysis patients are exposed to nearly 400- 500 liters of dialysate weekly, which is prepared by mixing up water for hemodialysis with concentrate for hemodialysis. The dialysate is separated from patient\u27s blood only by a se-mipermeable membrane. Therefore it has to satisfy the strict standards of microbiological quality. Beside reporting our own results, this paper deals with microbiological quality of water for hemodialysis and dialysate, its determination, its influence on health and modes of its control, taking into consideration that after cardiovascular diseases, infections are the most common cause of death in this population. Analysing the results of regular microbiological tests carried out during a 6-month period, it has been found that, in spite of regular disinfections of the central water for hemodialysis treatment system and hemodialysis machines, 10% of the samples of water for hemodialysis and 21.43% of the samples of dialysate do not comply to the AAMI standards. No other bacterial strain except Pseudomonas species was identified. During the observation period there were no pyrogenic reactions. The authors conclude that a significant percentage of the samples of water for hemodialysis and the samples of dialysate are not in accordance with the recommended standards. In spite of that, the obtained results do not differ significantly from the results of other authors