Monitoring the microbiological quality of dialysate and treated water

Abstract

During hemodialysis and related therapies, removal of waste products from the blood is made possible across a semi-permeable membrane. The microbiological quality of treated water (TW) and dialysate influences a number of dialysis-related complications. This article is a review of the microbiological features of TW and dialysate fluid over a six-year period (February 2007 to December 2012) in the Dialysis Unit, 1 st Medico-Surgical Hospital, Agadir, Morocco. Installation of a water treatment unit has been followed by a protocol to check its quality perio-dically. Results of microbiological monitoring (microorganisms and endotoxins) were collected over a six-year period. Fifty-four samples of TW and 12 samples of dialysate fluid were analyzed for colony forming units (CFU) and endotoxin during this period. All dialysate samples were negative, while in the TW, 9.2% of the samples yielded >100/mL CFU and 16.7% yielded >0.06 EU/mL of endotoxins. These abnormal results happened especially during the first two first years. More frequent disinfection of the distribution loop was the corrective measure. To obtain high-quality water for hemodialysis, the appropriate system must be continuously monitored in order to get high microbiological quality of TW and dialysate fluid.