Bacteriological monitoring of dialysis fluid in two haemodialysis centres in a Alexandria

ABSTRACT

Patients undergoing haemodialysis [HD] are exposed to large volumes of dialysis fluid and the bacteriological contamination of treated water and dialyste is therefore attracting increasing interest and concern. The present study aimed to assess the bacteriological quality of dialysis fluid in two HD units in Alexandria, Egypt. A total of 321 samples from water treatment system [WTS], treated water, concentrates and final dialysate were analyzed for the count of the total viable heterotrophic bacteria using the standard pour plate method, and for the determination of the total coliforms [TC] using the presence /absence method. Fifty random samples were also examined for endotoxin detection by the Limulus Amoebocyte Lysate assay, [LAL]. employing the gel clot method. The percentages of acceptable samples of WTS were 67% and 66.7% from unit A and B respectively while the dialysate samples showed higher acceptability at unit B [86.1%] than unit A [51.7%]. Eleven samples [4.9%] were detected having TC. LAL assay showed a range of 57% to 100% of samples exceeded 0.25 EU/ml The results demonstrate that haemodialysis centres need monitoring and preventive maintenance in order to ensure renal replacement therapy of good quality