الفهرس 
HaemodialysisOnly 14 pages are availabe for public view
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Abstract
Assurance of adequate water quality is one of the most important aspects of ensuring safe and effective delivery of haemodialysis to guarantee a better quality of life for the patients submitted to this treatment. Inadequate systems for water treatment, (systems in which water was not submitted to filtration and reverse osmosis) and inefficient methods of disinfection are responsible for the majority of outbreaks of bacteraemia and pyrogenia in patients in haemodialysis.
The incidence of non-fermenting gram-negative bacteria that can multiply rapidly even in the distilled water is high.
This study aimed to determine the microbiological quality of water samples and dialysate in a haemodialysis unit and to study the effect of dialysis machine filtration on bacterial count and endotoxin production.
Our study included eighty water and fluid samples collected from twenty haemodialysis machines from 3 haemodialysis units from water supply, dialysate, bicarbonate (before filtration) and after filtration. Detemination and detection of coliform bacteria, endotoxin production and biofilms were done.
A highly significant difference was found in before filtration samples as regards presence of bacterial contamination; being highest in bicarbonate followed by water and least by dialyate. A highly significant difference was found in the water supply, before and after filtration samples among the units A, B and C (P values < 0.001, <0.001 and 0.009 respectively).
Presence of bacterial contamination exceeding the standard limit was significantly different among before filtration samples present only in bicarbonate. No significant difference was found in the dialysate with P value 0.543.
A highly significant difference was found as regards bacterial content in bicarbonate between units A & B which use prepared bicarbonate and unit C which uses ready made bicarbonate with P value 0.003.
It was found that bacterial growth and endotoxin production were found in 15 machines before filtration and 11 machines after filtration with filtration in 4 machines “1 in unit A and 3 in unit B”. Biofilms were found in 9 machines.
It was concluded that rigorous control of water quality in haemodialysis services is extremely important in order to guarantee a better quality of life of the patients submitted to this treatment. Use of the ready-made bicarbonate is better than the use of prepared bicarbonate. Contamination may occur in the machines due to inadequate infection control measures