Effects of different procedures of disinfection on the bacteriologic quality of hemodialysis monitors of the Cobe CS3 and AK 100 type

]n recent years, hemodialysis treatment for chronic renal failure has been increasing. Although the technical evolutions have improved the therapy, the problem of microbial, toxic and chemical contamination of the dialysis fluid is now re-emerging. Most of all, because of increasing use of high-flux dialysis and its potential for transmembrane transport of bacteria into patients, one should be aware that dialysis fluid pathways may be colonised with bacteria. On the bacterial point of view, the French legislation proposed 100 CFU/mL as a maximum for total count of aerobic bacteria in the bi-osmosed water used for dilution of the dialysis concentrate. This study took place during 8 weeks in the children-hospital dialysis unit in Nancy (France). Our laboratory have succeeded in validating an aseptic bacteriological sampling procedure within fluid pathways of haemodialysis monitors Cobe CS3 and AK 100. It has also be shown that 6 to 12 hours of dialysis monitoring doesn't affect the quantitative and qualitative bacterial contamination of the biosmosed water (mean: 5 CFU/100 mL) drained through the 5 years' old internal pipes of the 2 monitors. So it has whatever the 4 different disinfection procedures applied and on the monitors (Formol or Formol + Citric acid + Chlorine or Heat or Heat + dehydrated Citric acid).