Human plasma and the antibacterial effect of peritoneal dialysis solutions

The influence of human plasma on the antibacterial effect of solutions for peritoneal dialysis was studied. The solutions contained 43 mEq per litre of either acetate or lactate as the source of base. Enough pooled human plasma was added to half of each solution to give a total concentration of a gramme of protein per litre. The numbers of viable organisms from 15 clinical isolates each of Staphylococcus aureus, Escherichia coli, and Pseudomonas species were counted before and after incubation in the four solutions. Numbers of viable Staph. aureus and E. coli diminished consistently after incubation in all four solutions, but the greatest decreases occurred in the acetate solution which contained no plasma. Plasma abolished the greater antibacterial effect of acetate on these organisms. Differences between numbers of viable Pseudomonas sp. after incubation in the four solutions were not significant. The diffusion of substances from plasma into dialysis fluids during peritoneal dialysis, therefore, may abolish the greater antibacterial effect of solutions made with acetate rather than lactate.