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Related Experiment Videos

Waterborne Pseudomonas septicemia.

R Vanholder1, E Vanhaecke, S Ringoir

  • 1Nephrology Department, University Hospital, Ghent, Belgium.

ASAIO Transactions
|July 1, 1990
PubMed
Summary
This summary is machine-generated.

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Septicemia outbreaks in dialysis patients can occur even with standard water quality controls. Total water decontamination is essential to prevent these Pseudomonas infections, especially when reusing dialyzers.

Area of Science:

  • Infectious Diseases
  • Nephrology
  • Public Health

Background:

  • Dialysis units require stringent water quality control to prevent patient infections.
  • Pseudomonas species are opportunistic pathogens that can cause severe infections in immunocompromised individuals, such as dialysis patients.
  • Waterborne septicemias pose a significant risk in healthcare settings, particularly for patients undergoing hemodialysis.

Purpose of the Study:

  • To investigate a cluster of Pseudomonas-related septicemias in a dialysis unit.
  • To identify the source and contributing factors of the infections.
  • To evaluate the effectiveness of standard water quality monitoring and dialyzer reprocessing procedures.

Main Methods:

  • Retrospective analysis of patient blood cultures and clinical data.

Related Experiment Videos

  • Microbiological testing of tap water, dialysate, and reprocessed dialyzers.
  • Evaluation of the automated dialyzer reprocessing device and its sterilization process.

    • Main Results:

    • A cluster of four pyrogenic reactions and three cases of septicemia caused by Pseudomonas species (P. aeruginosa, P. maltophilia, P. vesicularis) occurred in dialysis patients.
    • The infections were linked to the use of formaldehyde-reprocessed dialyzers.
    • Low formaldehyde concentrations and inadequate mixing of sterilant in the reprocessing device were identified as critical failures.
    • Pseudomonas species were detected in the tap water used for rinsing and in the effluent of reprocessed dialyzers.

    Conclusions:

    • Septicemias can occur despite adherence to preset bacterial contamination standards for water.
    • Inadequate sterilization during dialyzer reprocessing, even with standard disinfectants like formaldehyde, can lead to patient infections.
    • Total water decontamination is crucial for preventing waterborne infections in dialysis units, overriding standard bacterial count monitoring alone.