Comparison analysis of microbiological monitoring between hemodialysate and reverse osmosis water under different media

doi:10.3969/j.issn.1673-8640.2015.05.017

Abstract

Abstract: Objective To compare the difference between media, incubation temperatures and culture times on the choice of hemodialysate and reverse osmosis water for microbiological monitoring of heterotrophic plate count, and further to confirm the best culture method of microbiological monitoring for hemodialysate and reverse osmosis. Methods The polluted samples were simulated by using sterile dialysate and sterile reverse osmosis water, and then were incubated in 25℃ and 35℃ with eosin methylene blue agar(EMB), tryptone soy agar(TSA) and tryptone glucose extract agar(TGEA)for 48 h, 72 h and 7 d, respectively. Results Either on 25℃ or 35℃, the bacteria's growth condition in TGEA was better than those under other conditions(P<0.05). The colony numbers of 72 h incubation were more than those of 48 h incubation in all media(P<0.05). However, there was no statistical significance of colony numbers between 7 d incubation and 72 h incubation(P > 0.05). Conclusions The microbiological monitoring for hemodialysate and reverse osmosis water needs to use pour plate method with TGEA, incubating in 25℃ and 35℃ for 72 h, which may provide the effective reports for ensuring the safety of hemodialysis patients.

Key words: Hemodialysate, Reverse osmosis water, Heterotrophic plate count

CLC Number:

R446.11

ZHOU Yuechang, REN Lina, WANG Xuhui, CHEN Jianwen, CHEN Miaopei, MAO Hongzhong, HAN Lijie. Comparison analysis of microbiological monitoring between hemodialysate and reverse osmosis water under different media[J]. Laboratory Medicine, 2015, 30(5): 478-483.

Figures/Tables 6

References 25

[1]	CANAU B, BOSC JY, LERAY H, et al.Microbiological purity of dialysate for on-line substitution fluid preparation[J]. Nephrol Dial Transplant, 2000, 15(Suppl 2):21-30.
[2]	TATTERSALL JE,WARD RA, EUDIAL Group.Online haemodiafiltration:definition, dose quantification and safety revisited[J]. Nephrol Dial Transplant,2013,28(3): 542-550.
[3]	魏媛媛, 马迎春. 透析用水及透析液的微生物检测[J]. 中国血液净化,2014,13(4):335-339.
[4]	WARD DM. Hemodialysis water: an update on safety issues, monitoring,adverse clinical events[J]. ASAIO J,2004,50(6): Ⅹⅲ-Ⅹⅷ.
[5]	林明滢,王复德,王永卫.不同培养基测定菌落总数的比较[J].感控杂志,2001,11(5):289-298.
[6]	REASONER DJ.Heterotrophic plate count methodology in the United States[J]. Int J Food Microbiol,2004,92(3):307-315.
[7]	NYSTRAND R.Microbiology of water and fluids for hemodialysis[J]. J Chin Med Assoc,2008,71(5):223-229.
[8]	PONTORIERO G, POZZONI P, ANDRULLI S, et al. The quality of dialysis water[J]. Nephrol Dial Transplant,2003,18(Suppl 7): ⅶ21-ⅶ25.
[9]	SMEETS E, KOOMAN J, VAN DER SANDE F, et al. Prevention of biofilm formation in dialysis water treatment systems[J]. Kidney Int,2003,63(4):1574-1576.
[10]	RAY J.Microbiological monitoring of dialysis water systems-which culture method[J]. J Ren Care,2007,33(2):66-69.
[11]	JAMES R.Monitoring of dialysis water systems-is there a need for increased sampling[J]. EDTNA ERCA J,2006,32(2):74-77.
[12]	NYSTRAND R.The microbial world and fluids in dialysis[J]. Biomed Instrum Technol,2008,42(2):150-159.
[13]	JACKSON RW, OSBORNE K, BARNES G,et al.Multiregional evaluation of the SimPlate heterotrophic plate count method compared to the standard plate count agar pour plate method in water[J]. Appl Environ Microbiol,2000,66(1):453-454.
[14]	叶纯宜,林明滢,陈小妮,等.紫外线杀菌效能探讨[J].感控杂志,2005,15(5):293-300.
[15]	ROTH VR, JARVIS WR.Outbreaks of infection and/or pyrogenic reactions in dialysis patients[J]. Semin Dial,2000,13(2):92-96.
[16]	LEDEBO I, BLANKESTIJN PJ.Haemodiafiltration-optimal efficiency and safety[J]. NDT Plus,2010,3(1):8-16.
[17]	ASCI G, TZ H, OZKAHYA M, et al.The impact of membrane permeability and dialysate purity on cardiovascular outcomes[J]. J Am Soc Nephrol,2013,24(6):1014-1023.
[18]	NYSTRAND R.Official recommendations for quality of fluids in dialysis-the need for standardisation[J]. J Ren Care,2009,35(2): 74-81.
[19]	AMATO RL.Water treatment for hemodialysis--updated to include the latest AAMI standards for dialysate(RD52: 2004) continuing[J]. Nephrol Nurs J, 2005,32(2):151-167.
[20]	LAYMAN-AMATO R, CURTIS J, PAYNE GM.Water treatment for hemodialysis: an update[J]. Nephrol Nurs J,2013,40(5):383-404.
[21]	FENDLEY DA, WARD RA.Dialysate quality: new standards require a new approach to compliance[J]. Semin Dial,2012,25(5):510-515.
[22]	KAWASAKI T, UCHINO J, SHINODA T, et al.Guidance of technical management of dialysis water and dialysis fluid for the Japan Association for Clinical Engineering Technologists[J]. Blood Purif,2009,27(Suppl 1):41-49.
[23]	KAWANISHI H, MASAKANE I, TOMO T.The new standard of fluids for hemodialysis in Japan[J]. Blood Purif,2009,27(Suppl 1):5-10.
[24]	KAWANISHI H, AKIBA T, MASAKANE I, et al.Standard on microbiological management of fluids for hemodialysis and related therapies by the Japanese Society for Dialysis Therapy 2008[J].Ther Apher Dial,2009,13(2):161-166.
[25]	WARD RA.New AAMI standards for dialysis fluids[J]. Nephrol News Issues,2011,25(13):33-36.