Microbiological Analysis of Hemodialysis Water at the University Teaching Hospital of Yaounde, Cameroon

Cédric Gueguim; Nnanga Nga; François Kaze Folefack; Alain Ragon; Hortense Gonsu Kamga

doi:doi:10.11648/j.ajbls.20160406.11

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Microbiological Analysis of Hemodialysis Water at the University Teaching Hospital of Yaounde, Cameroon

Cédric Gueguim, Nnanga Nga, François Kaze Folefack, Alain Ragon, Hortense Gonsu Kamga

Published in American Journal of Biomedical and Life Sciences (Volume 4, Issue 6)

Received: 23 September 2016 Accepted: 5 November 2016 Published: 8 December 2016

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Abstract

Rigorous control of the microbiological quality of water in hemodialysis services is important because the immune system of patients with chronic renal failure is weakened. The objective of this study was to determine the microbiological quality of water for hemodialysis in the hemodialysis department of the University Teaching Hospital of Yaoundé in order to improve the disinfection strategy. Twelve water samples were collected each month at different sites of the hemodialysis circuits A (inlet of filters), B (Outlet of filters / inlet of Reverse Osmosis (RO) device) and C (outlet of the RO device / close to the generator) between July and October 2015 to be analyzed. The bacteria were isolated after filtration of 100 ml of water at each site through nitrocellulose membrane with 0.45 µm microporosity deposited on the surface of the Tryptone Glucose Extract Agar (TGEA) and then incubated at room temperature (20 to 22°C) for 7 days. After transplanting to different environments, pure bacterial isolates were identified by their cultural characters and marketed biochemical galleries. The colony count was well above the required international standards (>100 CFU / ml), for the hemodialysis water with a percentage of 83.3% (10/12) of non-compliance. Among the bacteria identified, nine (09) were Gram-negative bacilli including Pasteurella haemolytica, Pseudomonas fluorescens, Pseudomonas paucimobilis, Aeromonas salmonicida and Klebsiella pneumoniae subsp ozaenae, three (03) Gram-positive bacilli all Bacillus sp and six (06) Gram-positive cocci all of coagulase-negative staphylococci. The most frequently isolated bacterial genera were Pseudomonas (30.4%), Staphylococcus (26.1%), Aeromonas (13%), Bacillus (13%), Klebsiella (13%) and Pasteurella (4.3%). In this study, the high bacteriological contamination of the hemodialysis water with the detection of a variety of bacteria shows that the disinfection procedure of the distribution loop is not efficient and cannot prevent the development of a biofilm. A higher frequency of disinfection (almost every week), an increase of the concentration and time of contact of the chlorine disinfection product or the use of peracetic acid and a regular monitoring can contribute to improve the quality of the hemodialysis water at the CHUY to ensure a better quality of life for patients undergoing this treatment.

Published in	American Journal of Biomedical and Life Sciences (Volume 4, Issue 6)
DOI	10.11648/j.ajbls.20160406.11
Page(s)	81-86
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2016. Published by Science Publishing Group

Keywords

Water, Hemodialysis, Microbiology, Contamination, Disinfection

References

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[2]	Lima, E., Gazineu, M. H., Paiva, S. C., Rêgo, R. C., Salgueiro, A. (2003). A. Implementação do índice de qualidade de água para consumo (IQAC), na área urbana do município de Rio Formoso, PE. Higiene Alimentar. 17, 88-94.
[3]	Pisani, B., Simões, M., Prandi, M., Rocha, M., Gonçalves, C., Vaz, T., et al. (2000). Surto de bacteremia por Pseudomonas aeruginosa na unidade de hemodiálise de um hospital de Campinas, São Paulo, Brasil. Revue International Adolfo Lutz. 59 (1/2), 51-56.
[4]	Silva, A., Martins, C., Ferraboli, R., Jorgetti, V., Junior, R., Egidio, J. (1996). Revisão/Atualização em Diálise: Água para Hemodiálise Journal of Brasil Nefrology., 18(2), 180-188.
[5]	Riela, C., (2012). Princípios de Nefrologia e Distúrbios Hidroeletrolíticos. 3rd ed. Rio de Janeiro, Guanabara Koogan, p. 607-608.
[6]	Ragon, A. (2004). «l’eau et la santé dans les établissements de soins». These Edouard Kunegel, l’eau et les liquides de dialyse dans le traitement de l’insuffisance rénale chronique terminale. Soutenue publiquement le 27 juin 2013 pour obtenir le diplôme d’Etat de Docteur en pharmacie. Consulté le 3-02-2015.
[7]	Brunet, P., Berland, Y. (2000). Water quality and complications of haemodialysis. Nephrology Dialysis Transplantation., 15, 578-580.
[8]	Santos, F., Santos, A., Biernat, J., Souza, M., Raubach, A., Aguirre, A., et al. (2000). Detecção de endotoxina pelo teste do limulus amoebocyte lysate (LAL) em unidades de hemodiálise. Revue. Virt. Medicine. 54: 115-119.
[9]	Manedong F. (2013). Insuffisance rénale: 11 malades meurent au CHU - A cause du dysfonctionnement intervenu au centre d’hémodialyse; Cameroon infos, septembre 2013. Consulté le 13-01-2015.
[10]	Norme Française. (2008). Système de traitement et de distribution d’eau pour dilution des solutions concentrées pour hémodialyse – Exigences de conception, exploitation, performance et sécurité. S93-315: (2008).
[11]	Jaber, B. (2005). Bacterial infections in hemodialysis patients: pathogenesis and prevention. Kidney International journal. 67: 2508-2519.
[12]	Pontoriero, G., Pozzoni, P., Andrul, S., Locatelli, F. (2003). The quality of dialysis water. Nephrology Dialysis Transplantation., 18 (7): 21-25.
[13]	Hoenich, A. et Ronco, C. (2007). Hemodialysis fluid: composition and clinical importance. Blood Purification journal, 25: 62-68.
[14]	Montanari, B., Flávio, G., Miguel, J., Samuel, D., Regina, H., Clarice, et al. (2009). Microbiological contamination of a hemodialysis center water distribution system. Revue Internationale de Médecine tropicale. Sao. Paulo 51(1): 37-43.
[15]	Reis, J., Faria, N., Filter, A. (1998). Qualidade bacteriológica da água para hemodiálise do Distrito Federal. Revue. Saúde Distrito Federal, 9 (2): 180-189.
[16]	Oth, V., Jarvis, W. (2000). Outbreaks of infection and/or pyrogenic reaction in dialysis patients. Semin. Dialysis., 13: 92-96.
[17]	Arvanitidou, M., Vayona, A., Spanakis, N., Tsakris, A. (2003). Occurrence and antimicrobial resistance of Gram-negative bacteria isolated in haemodialysis water and dialysate of renal units: results of a Greek multicentre study. Journal of clinical Microbiology., 95: 180-185.
[18]	Zunino, P., Beltrán, L. (2002). Microbiological quality of hemodialysis water in a three-year multicenter study in Uruguay. Journal of Nephrology., 15: 374-379.
[19]	Arduino, M., Bland, L. A., Agüero, S. M. (1991). Comparison of microbiologic assay methods for hemodialysis fluids. Journal of clinical Microbiology., 29: 592-594.
[20]	Bambauer, R., Schauer, M., Jung, W., Daum, V., Vienken, J. (1994). Contamination of dialysis water and dialysate. A survey of 30 centers. ASAIO Journal., 40: 1012-1016.
[21]	Oie, S., Kamiya, A., Yoneda, I. (2003). Microbial contamination of dialysate and its prevention in haemodialysis units. Journal of Hospital Infection., 54: 115-119.

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APA Style

Cédric Gueguim, Nnanga Nga, François Kaze Folefack, Alain Ragon, Hortense Gonsu Kamga. (2016). Microbiological Analysis of Hemodialysis Water at the University Teaching Hospital of Yaounde, Cameroon. American Journal of Biomedical and Life Sciences, 4(6), 81-86. https://doi.org/10.11648/j.ajbls.20160406.11

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ACS Style

Cédric Gueguim; Nnanga Nga; François Kaze Folefack; Alain Ragon; Hortense Gonsu Kamga. Microbiological Analysis of Hemodialysis Water at the University Teaching Hospital of Yaounde, Cameroon. Am. J. Biomed. Life Sci. 2016, 4(6), 81-86. doi: 10.11648/j.ajbls.20160406.11

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AMA Style

Cédric Gueguim, Nnanga Nga, François Kaze Folefack, Alain Ragon, Hortense Gonsu Kamga. Microbiological Analysis of Hemodialysis Water at the University Teaching Hospital of Yaounde, Cameroon. Am J Biomed Life Sci. 2016;4(6):81-86. doi: 10.11648/j.ajbls.20160406.11

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@article{10.11648/j.ajbls.20160406.11,
  author = {Cédric Gueguim and Nnanga Nga and François Kaze Folefack and Alain Ragon and Hortense Gonsu Kamga},
  title = {Microbiological Analysis of Hemodialysis Water at the University Teaching Hospital of Yaounde, Cameroon},
  journal = {American Journal of Biomedical and Life Sciences},
  volume = {4},
  number = {6},
  pages = {81-86},
  doi = {10.11648/j.ajbls.20160406.11},
  url = {https://doi.org/10.11648/j.ajbls.20160406.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajbls.20160406.11},
  abstract = {Rigorous control of the microbiological quality of water in hemodialysis services is important because the immune system of patients with chronic renal failure is weakened. The objective of this study was to determine the microbiological quality of water for hemodialysis in the hemodialysis department of the University Teaching Hospital of Yaoundé in order to improve the disinfection strategy. Twelve water samples were collected each month at different sites of the hemodialysis circuits A (inlet of filters), B (Outlet of filters / inlet of Reverse Osmosis (RO) device) and C (outlet of the RO device / close to the generator) between July and October 2015 to be analyzed. The bacteria were isolated after filtration of 100 ml of water at each site through nitrocellulose membrane with 0.45 µm microporosity deposited on the surface of the Tryptone Glucose Extract Agar (TGEA) and then incubated at room temperature (20 to 22°C) for 7 days. After transplanting to different environments, pure bacterial isolates were identified by their cultural characters and marketed biochemical galleries. The colony count was well above the required international standards (>100 CFU / ml), for the hemodialysis water with a percentage of 83.3% (10/12) of non-compliance. Among the bacteria identified, nine (09) were Gram-negative bacilli including Pasteurella haemolytica, Pseudomonas fluorescens, Pseudomonas paucimobilis, Aeromonas salmonicida and Klebsiella pneumoniae subsp ozaenae, three (03) Gram-positive bacilli all Bacillus sp and six (06) Gram-positive cocci all of coagulase-negative staphylococci. The most frequently isolated bacterial genera were Pseudomonas (30.4%), Staphylococcus (26.1%), Aeromonas (13%), Bacillus (13%), Klebsiella (13%) and Pasteurella (4.3%). In this study, the high bacteriological contamination of the hemodialysis water with the detection of a variety of bacteria shows that the disinfection procedure of the distribution loop is not efficient and cannot prevent the development of a biofilm. A higher frequency of disinfection (almost every week), an increase of the concentration and time of contact of the chlorine disinfection product or the use of peracetic acid and a regular monitoring can contribute to improve the quality of the hemodialysis water at the CHUY to ensure a better quality of life for patients undergoing this treatment.},
 year = {2016}
}

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TY  - JOUR
T1  - Microbiological Analysis of Hemodialysis Water at the University Teaching Hospital of Yaounde, Cameroon
AU  - Cédric Gueguim
AU  - Nnanga Nga
AU  - François Kaze Folefack
AU  - Alain Ragon
AU  - Hortense Gonsu Kamga
Y1  - 2016/12/08
PY  - 2016
N1  - https://doi.org/10.11648/j.ajbls.20160406.11
DO  - 10.11648/j.ajbls.20160406.11
T2  - American Journal of Biomedical and Life Sciences
JF  - American Journal of Biomedical and Life Sciences
JO  - American Journal of Biomedical and Life Sciences
SP  - 81
EP  - 86
PB  - Science Publishing Group
SN  - 2330-880X
UR  - https://doi.org/10.11648/j.ajbls.20160406.11
AB  - Rigorous control of the microbiological quality of water in hemodialysis services is important because the immune system of patients with chronic renal failure is weakened. The objective of this study was to determine the microbiological quality of water for hemodialysis in the hemodialysis department of the University Teaching Hospital of Yaoundé in order to improve the disinfection strategy. Twelve water samples were collected each month at different sites of the hemodialysis circuits A (inlet of filters), B (Outlet of filters / inlet of Reverse Osmosis (RO) device) and C (outlet of the RO device / close to the generator) between July and October 2015 to be analyzed. The bacteria were isolated after filtration of 100 ml of water at each site through nitrocellulose membrane with 0.45 µm microporosity deposited on the surface of the Tryptone Glucose Extract Agar (TGEA) and then incubated at room temperature (20 to 22°C) for 7 days. After transplanting to different environments, pure bacterial isolates were identified by their cultural characters and marketed biochemical galleries. The colony count was well above the required international standards (>100 CFU / ml), for the hemodialysis water with a percentage of 83.3% (10/12) of non-compliance. Among the bacteria identified, nine (09) were Gram-negative bacilli including Pasteurella haemolytica, Pseudomonas fluorescens, Pseudomonas paucimobilis, Aeromonas salmonicida and Klebsiella pneumoniae subsp ozaenae, three (03) Gram-positive bacilli all Bacillus sp and six (06) Gram-positive cocci all of coagulase-negative staphylococci. The most frequently isolated bacterial genera were Pseudomonas (30.4%), Staphylococcus (26.1%), Aeromonas (13%), Bacillus (13%), Klebsiella (13%) and Pasteurella (4.3%). In this study, the high bacteriological contamination of the hemodialysis water with the detection of a variety of bacteria shows that the disinfection procedure of the distribution loop is not efficient and cannot prevent the development of a biofilm. A higher frequency of disinfection (almost every week), an increase of the concentration and time of contact of the chlorine disinfection product or the use of peracetic acid and a regular monitoring can contribute to improve the quality of the hemodialysis water at the CHUY to ensure a better quality of life for patients undergoing this treatment.
VL  - 4
IS  - 6
ER  -

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Author Information

Cédric Gueguim

Departement of Biochemistry, University of Yaounde I, Central Region, Cameroon
Nnanga Nga

Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Central Region, Cameroon
François Kaze Folefack
Alain Ragon

Division of Uro-Nephrology Laboratory, Hospital of Conception, Marseille, France
Hortense Gonsu Kamga

Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Central Region, Cameroon

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Cédric Gueguim, Nnanga Nga, François Kaze Folefack, Alain Ragon, Hortense Gonsu Kamga. (2016). Microbiological Analysis of Hemodialysis Water at the University Teaching Hospital of Yaounde, Cameroon. American Journal of Biomedical and Life Sciences, 4(6), 81-86. https://doi.org/10.11648/j.ajbls.20160406.11

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ACS Style

Cédric Gueguim; Nnanga Nga; François Kaze Folefack; Alain Ragon; Hortense Gonsu Kamga. Microbiological Analysis of Hemodialysis Water at the University Teaching Hospital of Yaounde, Cameroon. Am. J. Biomed. Life Sci. 2016, 4(6), 81-86. doi: 10.11648/j.ajbls.20160406.11

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AMA Style

Cédric Gueguim, Nnanga Nga, François Kaze Folefack, Alain Ragon, Hortense Gonsu Kamga. Microbiological Analysis of Hemodialysis Water at the University Teaching Hospital of Yaounde, Cameroon. Am J Biomed Life Sci. 2016;4(6):81-86. doi: 10.11648/j.ajbls.20160406.11

Copy | Download

@article{10.11648/j.ajbls.20160406.11,
  author = {Cédric Gueguim and Nnanga Nga and François Kaze Folefack and Alain Ragon and Hortense Gonsu Kamga},
  title = {Microbiological Analysis of Hemodialysis Water at the University Teaching Hospital of Yaounde, Cameroon},
  journal = {American Journal of Biomedical and Life Sciences},
  volume = {4},
  number = {6},
  pages = {81-86},
  doi = {10.11648/j.ajbls.20160406.11},
  url = {https://doi.org/10.11648/j.ajbls.20160406.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajbls.20160406.11},
  abstract = {Rigorous control of the microbiological quality of water in hemodialysis services is important because the immune system of patients with chronic renal failure is weakened. The objective of this study was to determine the microbiological quality of water for hemodialysis in the hemodialysis department of the University Teaching Hospital of Yaoundé in order to improve the disinfection strategy. Twelve water samples were collected each month at different sites of the hemodialysis circuits A (inlet of filters), B (Outlet of filters / inlet of Reverse Osmosis (RO) device) and C (outlet of the RO device / close to the generator) between July and October 2015 to be analyzed. The bacteria were isolated after filtration of 100 ml of water at each site through nitrocellulose membrane with 0.45 µm microporosity deposited on the surface of the Tryptone Glucose Extract Agar (TGEA) and then incubated at room temperature (20 to 22°C) for 7 days. After transplanting to different environments, pure bacterial isolates were identified by their cultural characters and marketed biochemical galleries. The colony count was well above the required international standards (>100 CFU / ml), for the hemodialysis water with a percentage of 83.3% (10/12) of non-compliance. Among the bacteria identified, nine (09) were Gram-negative bacilli including Pasteurella haemolytica, Pseudomonas fluorescens, Pseudomonas paucimobilis, Aeromonas salmonicida and Klebsiella pneumoniae subsp ozaenae, three (03) Gram-positive bacilli all Bacillus sp and six (06) Gram-positive cocci all of coagulase-negative staphylococci. The most frequently isolated bacterial genera were Pseudomonas (30.4%), Staphylococcus (26.1%), Aeromonas (13%), Bacillus (13%), Klebsiella (13%) and Pasteurella (4.3%). In this study, the high bacteriological contamination of the hemodialysis water with the detection of a variety of bacteria shows that the disinfection procedure of the distribution loop is not efficient and cannot prevent the development of a biofilm. A higher frequency of disinfection (almost every week), an increase of the concentration and time of contact of the chlorine disinfection product or the use of peracetic acid and a regular monitoring can contribute to improve the quality of the hemodialysis water at the CHUY to ensure a better quality of life for patients undergoing this treatment.},
 year = {2016}
}

Copy | Download

TY  - JOUR
T1  - Microbiological Analysis of Hemodialysis Water at the University Teaching Hospital of Yaounde, Cameroon
AU  - Cédric Gueguim
AU  - Nnanga Nga
AU  - François Kaze Folefack
AU  - Alain Ragon
AU  - Hortense Gonsu Kamga
Y1  - 2016/12/08
PY  - 2016
N1  - https://doi.org/10.11648/j.ajbls.20160406.11
DO  - 10.11648/j.ajbls.20160406.11
T2  - American Journal of Biomedical and Life Sciences
JF  - American Journal of Biomedical and Life Sciences
JO  - American Journal of Biomedical and Life Sciences
SP  - 81
EP  - 86
PB  - Science Publishing Group
SN  - 2330-880X
UR  - https://doi.org/10.11648/j.ajbls.20160406.11
AB  - Rigorous control of the microbiological quality of water in hemodialysis services is important because the immune system of patients with chronic renal failure is weakened. The objective of this study was to determine the microbiological quality of water for hemodialysis in the hemodialysis department of the University Teaching Hospital of Yaoundé in order to improve the disinfection strategy. Twelve water samples were collected each month at different sites of the hemodialysis circuits A (inlet of filters), B (Outlet of filters / inlet of Reverse Osmosis (RO) device) and C (outlet of the RO device / close to the generator) between July and October 2015 to be analyzed. The bacteria were isolated after filtration of 100 ml of water at each site through nitrocellulose membrane with 0.45 µm microporosity deposited on the surface of the Tryptone Glucose Extract Agar (TGEA) and then incubated at room temperature (20 to 22°C) for 7 days. After transplanting to different environments, pure bacterial isolates were identified by their cultural characters and marketed biochemical galleries. The colony count was well above the required international standards (>100 CFU / ml), for the hemodialysis water with a percentage of 83.3% (10/12) of non-compliance. Among the bacteria identified, nine (09) were Gram-negative bacilli including Pasteurella haemolytica, Pseudomonas fluorescens, Pseudomonas paucimobilis, Aeromonas salmonicida and Klebsiella pneumoniae subsp ozaenae, three (03) Gram-positive bacilli all Bacillus sp and six (06) Gram-positive cocci all of coagulase-negative staphylococci. The most frequently isolated bacterial genera were Pseudomonas (30.4%), Staphylococcus (26.1%), Aeromonas (13%), Bacillus (13%), Klebsiella (13%) and Pasteurella (4.3%). In this study, the high bacteriological contamination of the hemodialysis water with the detection of a variety of bacteria shows that the disinfection procedure of the distribution loop is not efficient and cannot prevent the development of a biofilm. A higher frequency of disinfection (almost every week), an increase of the concentration and time of contact of the chlorine disinfection product or the use of peracetic acid and a regular monitoring can contribute to improve the quality of the hemodialysis water at the CHUY to ensure a better quality of life for patients undergoing this treatment.
VL  - 4
IS  - 6
ER  -

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