IJEP 41(11): 1306-1309 : Vol. 41 Issue. 11 (November 2021)
Yasamen Raad Humudat* and Saadi Kadhim Al-Naseri
Environment and Water Directorate, Ministry of Science and Technology, Baghdad, Iraq
Abstract
Microbiological monitoring of the water used for hemodialysis plays a crucial role in ensuring adequate quality service for patients suffering from renal failure. The aim of this study was to investigate the bacteriological characteristics of the dialysis water (feed and produced) used at dialysis centers of four hospitals in Baghdad. In this work, a total of 48 water samples from the municipal drinking water, dialysis water and water samples from dialysis pipes distribution were analyzed for heterotrophic plate count using the membrane filters technique over one year to evaluate seasonal effects. Among these fluids used in hemodialysis, water samples of the dialysis pipes distribution were most frequently contaminated and had the highest concentration of bacteria. Samples examined from the distribution of dialysis water pipes, 43.75% showed a bacterial count of more than 50 colony forming units (CFU/mL), which was above the action level as compared to international standards. Therefore, a water quality management programme including monitoring, maintenance and development of water treatment systems in hemodialysis centers is extremely necessary to reduce the risk of contamination for patients suffering from hemodialysis. Moreover, a suitable disinfection programme is required to ensure better control of bacterial growth and the formation of biofilms.
Keywords
Hemodialysis, Microbiological Contamination, Dialysis water, Dialysis fluid
References
- Abbass, A. A., et al. 2018. Microbiological monitoring of ultrapure dialysis fluid in a hemodialysis center in Alexandria, Egypt. Alexandria j. medicine. 54 (4): 523-527.
- Humudat, Y. R., S. K. Al Naseri and Y. F. Al Fatlawy. 2020. Assessment of microbial contamination levels of water in hemodialysis centers in Baghdad, Iraq. Water Env. Res., 92(9):1325-1333.
- Nystrand, R. 2008. Microbiology of water and fluids for hemodialysis. J. Chinese medical assoc., 71 (5): 223-229.
- Andersson, J. and E. Holmström. 2016. On-line verification of hemodialysis water quality. Masters Thesis. Biomedical Engineering, Faculty of Engineering, Lund University, baxter.
- Iraqi Ministry of Health. 2019. Annual statistical report 2017. Ministry of Health and Environment, Republic of Iraq.
- Humudat, Y. R., S. K. Al-Naseri and Y. F. Al-Fatlawy. 2019. Assessment of inflammation, comorbidity and demographic factors in patients with kidney disease in Baghdad. Iraqi J. Sci., 60 (11): 2418-2425.
- Tentori, F., et al. 2012. Longer dialysis session length is associated with better intermediate outcomes and survival among patients on in-center three times per week hemodialysis: results from the dialysis outcomes and practice patterns study (DOPPS). Nephrology Dialysis Transplantation. 27 (11): 4180-4188.
- Hamoudat, Y. 2009. Evaluating dialysis fluids properties and its effects on hemodialysis patients at several hospitals in Baghdad. Ph.D Thesis. University of Baghdad, Republic of Iraq.
- Elaziz, H. A., B. K. Abdalla and S. Mergani. 2017. Characterization and improved treatment of dialysis water. J. Basic Appl. Sci., 7 (1): 269-274.
- Montanari, L. B., et al. 2009. Microbiological contamination of a hemodialysis center water distribution system. J. São Paulo Institute Tropical Medicine. 51 (1): 37-43.
- Okunola, O. O. and J.O. Olaitan. 2016. Bacterial contamination of hemodialysis water in three randomly selected centers in south western Nigeria. Nigerian J. Clinical Practice. 19 (4): 491-495.
- ISO 23500-5. 2019. Preparation and quality management of fluids for haemodialysis and related therapies — Part 5: Quality of dialysis fluid for haemodialysis and related therapies. International Standards Organization, Switzerland.
- ANSI/AAMI/ISO23500. 2019. Preparation and quality management of fluids for haemodialysis and related therapies—Part 5: Quality of dialysis fluid for haemodialysis and related therapies. Association for the Advancement of Medical Instrumentation. American National Standard Institute, Arlington, Varginia, USA.
- ANSI/AAMI/ISO13959. 2014. New AAMI water quality standard for hemodialysis. Association for the Advancement of Medical Instrumentation. American National Standard Institute, Arlington, Varginia, USA.
- Iraqi Criteria and Standards 2270. 2011. Microbiological limits of drinking water and edible ice (part 14). Central organization for Standardization and Quality Control, Minisitry of Planning, Republic of Iraq.
- Stigant, C. E., O. Djurdjev and A. Levin. 2005. C-reactive protein levels in patients on maintenance hemodialysis: Reliability and reflection on the utility of single measurements. Int. Urol. Nephron., 37(1):133-140.
- Hoenich, N. A., C. Ronco and R. Levin. 2006. The importace of water quality and hemodialysis fluid composition. Blood purification. 24 (1): 11-18.
- Kale, V. S. 2016. Consequence of temperature, ph, turbidity and dissolved oxygen water quality parameters. Int. Adv. Res. J. Sci. Eng. Tech., 3 (8): 186-190.
- Al Naseri, S. K., Z. M. Mahdi and M. F. Hashim. 2013. Quality of water in hemodialysis centers in Baghdad, Iraq. Hemodialysis Int., 17(4): 517-522.
