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Excessive Levels of Gram-Negative Bacteria in Hemodialysis Machines Because of Inadequate Cleaning Guidelines

Published online by Cambridge University Press:  02 January 2015

Inge Gurevich ,
Fay Williams  and
Burke A. Cunha
Inge Gurevich
Affiliation:
Infection Control Section, Infectious Disease Division Department of Medicine, and the Department of Pathology, Nassau Hospital, Mineola, New York
Fay Williams
Affiliation:
Infection Control Section, Infectious Disease Division Department of Medicine, and the Department of Pathology, Nassau Hospital, Mineola, New York
Burke A. Cunha*
Affiliation:
Infection Control Section, Infectious Disease Division Department of Medicine, and the Department of Pathology, Nassau Hospital, Mineola, New York
*
Infectious Disease Division, Nassau Hospital, 259 First St., Mineola, NY 11501
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Abstract

The possibility of sepsis or pyrogenic reaction increases in hemodialysis patients as coliform or other gram-negative counts in the dialysis water reach levels ≥ 1000 colonies/ml. After the introduction of Cobe Century II dialysis machines (Cobe, Lakewood, Colorado), routine testing of dialysis water samples revealed gram-negative bacteria in concentrations up to 45,000 colonies/ml. An epidemiologic investigation was performed to determine the source of the bacterial contamination. The amounts of disinfectant solution were increased, but bacterial counts remained unacceptably high. A study of the fluid path within the machines revealed that part of that path was not reached at all by the disinfectant. In addition, the disinfectant was automatically and improperly diluted. Therefore, increased bacterial counts could not be reduced satisfactorily by using the manufacturer's disinfection guidelines.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 2 , Issue 5 , October 1981 , pp. 373 - 376
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1981

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References

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