Microbiological surveillance and state of the art technological strategies for the prevention of dialysis water pollution.
METHODS
The present report attempts to illustrate the positive impact on the microbiological quality of dialysis patients over a 15-year period through the progressive implementation of state-of-the-art technological strategies and the optimization of microbiological surveillance procedures in five dialysis units in Sardinia.


RESULTS
Following on better microbiological, quality controls of dialysis water and improvement of procedures and equipment, a drastic improvement of microbiological water quality was observed in a total of 945 samples. The main aim was to introduce the use of microbiological culture methods as recommended by the most important guidelines. The microbiological results obtained have led to a progressive refining of controls and introduction of new materials and equipment, including two-stage osmosis and piping distribution rings featuring a greater capacity to prevent biofilm adhesion. The actions undertaken have resulted in unexpected quality improvements.


CONCLUSIONS
Dialysis water should be viewed by the nephrologist as a medicinal product exerting a demonstrable positive impact on microinflammation in dialysis patients. A synergic effort between nephrologists and microbiologists undoubtedly constitutes the most effective means of preventing dialysis infections.
Territorial Department of Nephrology and Dialysis, ASL, Quartu Sant'Elena, Cagliari 09045, Italy.
Piergiorgio
P
Bolasco
University Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari 09121, Italy.
Antonio
A
Contu
University Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari 09121, Italy.
Patrizia
P
Meloni
University Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari 09121, Italy.
Dorio
D
Vacca
Territorial Department of Nephrology and Dialysis, ASL, Quartu Sant'Elena, Cagliari 09045, Italy.
Andrea
A
Galfrè
D017408:Guidelines as Topic; D006435:Renal Dialysis / Q000295:instrumentation / Q000592:standards*; D014871:Water Microbiology; D014876:Water Pollution / Q000517:prevention & control*; D060753:Water Quality