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Related Experiment Videos

Peritonitis from automated peritoneal dialysis.

B H Hamory, J M Neviakias, S K Pearson

    Infection Control : IC
    |December 1, 1984
    PubMed
    Summary
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    Automated peritoneal dialysis patients developed peritonitis from a gram-negative rod found in the dialysis machine and its water supply. Higher formaldehyde concentrations eradicated the persistent bacteria.

    Area of Science:

    • Nephrology
    • Infectious Diseases
    • Medical Device Contamination

    Background:

    • Automated peritoneal dialysis (APD) is a crucial treatment for end-stage renal disease.
    • Peritonitis is a serious complication of peritoneal dialysis, requiring prompt diagnosis and treatment.
    • Identifying the source of infection is vital for preventing recurrent outbreaks.

    Observation:

    • Three consecutive patients undergoing APD developed peritonitis caused by a nonfermenting gram-negative rod.
    • The identical organism was isolated from the APD machine's dialysate and its tap water supply.
    • This represents the first reported outbreak where the causative agent was traced to the machine's tap water source.

    Findings:

    • The nonfermenting gram-negative rod contaminated the APD system via the tap water supply.

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  • Standard 3% formaldehyde disinfection failed to eradicate the persistent organism from the dialysis machine.
  • A higher concentration of 10% formaldehyde was effective in eliminating the bacteria.

    • Implications:

    • Tap water sources for APD machines require rigorous monitoring to prevent infectious outbreaks.
    • Standard disinfection protocols for APD machines may need revision to address resistant organisms.
    • This highlights the importance of source identification in managing APD-related peritonitis.