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Should dialysis machines be disinfected between patients' shifts?

A Stragier1, M Jadoul

  • 1Université Catholique de Louvain, Cliniques Universitaires St.Luc, Renal Unit, Brussels, Belgium. Andre.Stragier@pandora.be

EDTNA/ERCA Journal (English Ed.)
|November 6, 2003
PubMed

Insights

Routine dialysis machine disinfection after each session does not prevent Hepatitis C Virus (HCV) infection. Enhanced general hygiene is key for patient safety in dialysis units.

Area of Science:

  • Nephrology
  • Infectious Disease Control
  • Healthcare-Associated Infections

Background:

  • Dialysis machine disinfection protocols vary, with some units disinfecting after each session and others daily.
  • Hepatitis C Virus (HCV) transmission remains a concern in hemodialysis settings.
  • Previous studies suggest general hygiene reinforcement may impact infection rates.

Purpose of the Study:

  • To evaluate the impact of dialysis machine disinfection frequency on HCV sero-conversion rates.
  • To assess the effect of disinfection policies on dialysate bacterial and endotoxin levels.
  • To determine if systematic post-session disinfection is necessary for infection prevention.

Main Methods:

  • A multicenter study involving 15 dialysis units (5 with post-session disinfection, 10 without).
  • Reinforcement of general hygiene precautions was implemented across all units.
  • Second investigation compared dialysate quality in machines with different disinfection frequencies (n=2 each).

Main Results:

  • HCV sero-conversion incidence was zero in all units after hygiene reinforcement, irrespective of disinfection policy.
  • No significant difference in dialysate bacterial or endotoxin levels was found between machines disinfected after each session versus daily.
  • Blood contamination beyond pressure transducers highlights the need for improved general hygiene.

Conclusions:

  • Systematic disinfection of dialysis machines after each session does not appear to prevent HCV infection.
  • Current disinfection policies have no detectable impact on optimal dialysate bacterial and endotoxin characteristics.
  • Focusing on enhanced general hygiene and equipment inspection is crucial for infection control in dialysis.

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