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[Disinfection is prevention]
F Conti1, V Besutti, M C Magagnotti
1Servizio Emodialisi, Divisione Clinicizzata di Nefrologia, Verona, Italy.
Abstract:
Prevention of outbreaks is very important in haemodialysis units because of the high risk of infectious complications caused by contaminated water or equipment. Our aim was to evaluate the efficiency of a chloride based disinfectant for haemodialysis machines. Five different machines were tested for infection by culturing water drawn from both inlet (point A) and outlet (point B) of the dialyser and from the waste site (point C). Six series of tests were analysed during a 3-week period. In the first week water was drawn from point A before and after disinfection on two different days; during the second and third weeks the same procedure was performed at points B and C, respectively. Three non-contaminated samples of 2 mL each were sent to the microbiology department for cultures. Samples from point B grew a number of bacteria even after the disinfectant for the water system was changed. We conclude that machine contamination is due to patients and, therefore, a very accurate cleaning and disinfection of system components is essential. This procedure can avoid isolation of infected patients. Prevention of infection is a complex procedure and should engage water systems, machines, as well as environment and nurses.
Insights
Preventing haemodialysis outbreaks requires rigorous disinfection. A chloride-based disinfectant proved insufficient, indicating patient contamination necessitates enhanced cleaning protocols for haemodialysis machines and systems.
Area of Science:
- Infectious Disease Epidemiology
- Biomedical Engineering
- Microbiology
Context:
- Haemodialysis units face high infection risks from contaminated water and equipment.
- Outbreak prevention is critical to patient safety in haemodialysis settings.
Purpose:
- To evaluate the efficacy of a chloride-based disinfectant in preventing haemodialysis machine contamination.
- To identify sources of microbial contamination within haemodialysis machines.
Summary:
- Testing involved culturing water from haemodialysis machine inlets, outlets, and waste sites over three weeks.
- Bacterial growth persisted at the dialyser outlet (point B) even after disinfectant changes.
- Findings suggest patient-related factors contribute significantly to machine contamination.
Impact:
- Highlights the need for meticulous cleaning and disinfection of haemodialysis systems to prevent patient isolation.
- Emphasizes a comprehensive infection control strategy involving water systems, machines, environment, and nursing staff.