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2014, Number 2

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Revista Cubana de Salud Pública 2014; 40 (2)

Health importance of Pseudomonas aeruginosa in hemodyalisis water and its disinfection

González GMI, García MM, Mariné AMÁ

Language: Spanish
References: 33
Page: 201-214
PDF size: 220.86 Kb.


ABSTRACT

Introduction: microbiological contamination of the hemodialysis water treatment is a present problem mainly because of the persistence of certain microorganisms in the biofilm formation, such as the case of Pseudomonas aeruginosa.
Objective: to update the knowledge on the health importance of Pseudomonas aeruginosa and their disinfection in hemodialysis water for adequate decision-making.
Methods: data were taken from international bodies such as the Association for the Advancement of Medical Instruments, the International Standardization Organization, expert criteria and lab results as well as work guidelines.
Information synthesis: there are different ways of acting upon the bacterial contamination; one of them is to prevent it. This can be accomplished if certain elements of the system are improved to create a turbulent flow that prevents the presence of biofilm; it may also be attained by using heat or disinfectant chemical products that should be validated. However, for the purpose of preventing the presence of Pseudomonas aeruginosa and other microorganisms, emphasis must be made on regular and preventive cleaning and disinfection of all the parts of the water treatment and distribution systems and of the hemodialysis equipment.
Conclusions: the process of disinfection of Pseudomonas aeruginosa in a water treatment plant is casuistic, taking into account the diversity of water treatment systems, distribution systems, operating time and need of taking point measures aimed at each of them.


REFERENCES

  1. Ward RA, Ing TS. II Bloodbased Therapies. 5. Product water and hemodialysis solution preparation. En: Daugirdas JT, Blake, PG, Ing TS, editors. Handbook of dialysis, 4ta ed. USA: Lippincott Williams & Wilkins, PA; 2007. p.79-86.

  2. Association for the Advancement of Medical Instrumentation. Dialysate for Hemodialysis, 2004. ANSI/AAMI RD. 2004:52.

  3. Association for the Advancement of Medical Instrumentation. Water treatment equipment for hemodialysis equipment. 2007. ANSI/AAMI RD. 2006:62.

  4. ISO/DIS 23500: 2010. Guidance for the preparation and quality management of fluids for haemodialysis and related therapies. Ginebra: ISO/DIS; 2010.

  5. García M, González MI, Mariné MA. Criterios para la vigilancia de la calidad química y microbiológica del agua para hemodiálisis. Rev Cubana Higiene Epidemiol. 2013;51(2):192-202.

  6. Arduino MJ, Patel PR, Thompson ND, Favero MS. Hemodialysis-associated infections. En: Himmelfarb J, Sayeh MH, editors. Chronic Kidney Diseases, Dialysis and Transplantation. 3ra. ed. USA: Saunders Elsevier, PA; 2010. p. 335-53.

  7. Torres T, Esnard SC, Guillermo SM, Díaz O. Estudio microbiológico del agua para hemodiálisis. Rev Cubana Higiene Epidemiol. 1999 [citado 11 Sept 2013];37(1):21-4. Disponible en: http://scielo.sld.cu/scielo.php?pid=S156130031999000100004&script=sci_arttext

  8. Rodríguez AU, Delgado M, Dujarric MD. Vigilancia químico-bacteriológica de las agua de sistemas de hemodiálisis en instituciones seleccionadas. Rev Cubana Higiene Epidemiol. 2007 [citado 11 Sept 2013];45(3):1-5. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561 -30032007000300006

  9. Espinosa F. Patógenos multirresistentes emergentes. Hospital “Hermanos Ameijeiras”. 2009. Rev Acta Médica. 2011;13(1):38-45.

  10. Mena D, Gerba Ch. Risk assessment of Pseudomonas aeruginosa in water. Rev Environ Contaminat Toxicol. 2009;201:71-115.

  11. Pasmore M. Biofilms in Haemodialysis. En: The Role of Biofilms in Device-Related Infections. Vol 3. Springer Series on Biofilms Heidelberg: Springer-Verlag; 2009.

  12. Trautmann M, Lepper PM, Haller M. Ecology of Pseudomonas aeruginosa in the intensive care unit and the evolving role of water outlets as a reservoir of the organism. Amer J Infect Control. 2005;33(5 supp1):41-9.

  13. Gómez Y, González MI, Chiroles S, García C. Calidad microbiológica del agua utilizada en la Unidad de Hemodiálisis del Instituto de Nefrología. Rev Cubana Higiene Epidemiol. 2006 [citado 11 Sept 2013];44(1) 1-6. Disponible en: http://scielo.sld.cu/scielo.php?pid=S156130032006000100003&script=sci_arttext

  14. Mariné MA, García M. Protocolos para la contratación y puesta en marcha de plantas de tratamiento de agua para hemodiálisis. Rev Cubana Higiene Epidemiol. 2011[citado 11 Sept 2013];49(3):410-9. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561 -30032011000300009

  15. Todar K. Todar´s Online Textbook of Bacteriology. EE. UU.: University of Wisconsin. [cited 2013 Sept 11]. Available from: http://www.textbookofbacteriology.net/pseudomonas.html

  16. Driscoll JA, Brody SL, Kollef MH. The epidemiology, pathogenesis and treatment of Pseudomonas aeruginosa infections. Drugs. 2007(3):351-68.

  17. Palleroni NJ. The genus Pseudomonas. En: Goldman E, Green LH, editors. Handbook of Microbiology. Boca Raton, Fla.: CRC Press Taylor and Francis Group; 2008. p. 231-42.

  18. Uzcudun IL. Biofilm bacterianos. Actualidad SEM. 2004 [citado 1 Sept 2013](37):14-18. Disponible en: http://www.semicrobiologia.org/pdf/actualidad /SEM37_14.pdf

  19. Capelli G, Riccardi M, Perrone S, Bonde M, Ligabue G, Albertassi A. Water treatment and monitor disinfection. Hemodialysis Internat. 2006;10(suppl 1): S13-S18.

  20. Amara AA. Opportunistic pathogens and their biofilm ¨Food for thought¨. En: Méndez-Vila, editor. Science against microbial pathogens: communicating current research and technological advances. Microbiology Book Series Vol.3 (2). España: FORMATEX Research Center; 2011. p. 813-25.

  21. Bjarnshot T, Tolker-Nilesen T, Hÿiby N, Givskov M. Interference of Pseudomonas aeruginosa signaling and biofilm formation for infection control. Expert Review Mol Med. 2010;12 (11):1-13.

  22. Bolasco P, Contu A, Meloni P, Vacca D, Galfré A. Microbiological surveillance and state of the art technological strategies for the prevention of dialysis water pollution. Int J Environ Res Public Health. 2012;9(8):2758-71.

  23. Recommendations for preventing transmission of infections among Chronic Hemodialysis Patients. MMWR. 2001:27:50(RR-5):1-43.

  24. Ortega E. Control de infecciones y seguridad de los pacientes en hemodiálisis. Revista ECI. 2010;2(4):270-80.

  25. Pérez-García R, Rodríguez-Benítez POC. Why and how to monitor bacterial contamination of dialysate? Nephrol Dialysis Transplant. 2000;15(6):760-4.

  26. Pizarelli F, Cerrai T, Biagini M. Dialysis water treatment systems and monitoring in Italy. Results of a national survey. J Nephrol. 2004;17(4):565-9.

  27. Pérez-García R, Rodriguez-Benítez POC. La calidad del líquido de diálisis. 2do. Congreso Internacional de Nefrología. España. 2001[citado 1 Abr 2013]. Disponible en: http://www.uninet-edu/cin2001-old/conf/perez /perez.html

  28. Nystrand R. The microbial world and fluids in dialysis. Biomed Instrumentation Technol. 2008;42(5):150-9.

  29. Favero MS. Dialysis-associated diseases and their control. En: Bennett JV, Brachman PS, editors. Hospital Infec. 2sd ed. Boston: Little Brown and Company; 1985. p. 267-84.

  30. Holmes CJ, Degremont A, Kubey W, Straka P, Man NK. Effectiveness of various chemical disinfectants versus cleaning combined with heat disinfection on Pseudomonas biofilm in hemodialysis machines. Blood Purificat. 2004;22(5):461-468.

  31. Suman E, Varghese B, Joseph N, Nisha K, Kotian MS. The bacterial biofilms in dialysis water systems and the effect of the sub inhibitory concentrations of chlorine on them. J Clin Diagnostic Res. 2013;7(5):849-52.

  32. Ducki S, Francini N, Blech M-F. Water used for hemodialysis equipment: where is Pseudomonas aeruginosa? Néphrologie Thérapeutique. 2005;1(2):126-30.

  33. Small DA, Chang W, Toghrol F, Bentley WE. Comparative global transcription analysis of sodium hypochlorite, peracetic acid, and hydrogen peroxide on Pseudomonas aeruginosa. App Microbiol Biotechnol. 2007:76(5):1093-105.




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