Prevent infection linked to the dialysis water in a hemodialysis center in Fez city (Morocco).
BACKGROUND
Water treatment systems are a critical variable in dialysis therapy. Rigorous control of hemodialysis water quality is particularly important in order to guarantee a better quality of life of the hemodialysis patients. The objective of the study was to evaluate the chemical, microbiological quality and antimicrobial resistance of bacteria isolated from water and dialysate in a public HD center.


METHODS
Fifty five samples of water and dialysate were collected weekly over a period of 4 months. The samples were collected from 4 points in the distribution loop. The microbiological and chemical analyses were performed according to our national standards. Antimicrobial susceptibilities patterns of isolated bacteria were determined by disk diffusion method.


RESULTS
The chemical and microbiological parameters in all dialysis water and dialysate samples are in accordance with national standards. However, 70 Gram-negative bacteria were identified: Pseudomonas sp, Ochrobactrum antropi and Burkholderia cepacia, isolated at 52.8%, 12.8% and 17% simultaneously. Fourteen per cent of the isolates were resistant to three or more antibiotics. All resistant bacteria belong to the genus of Pseudomonas, 80% were resistant to tetracycline and to co-trimoxazole, 30% to ceftazidime. No colistin and imipenem resistance was observed.


CONCLUSIONS
To avoid a health risk due to bacterial contamination, an adequate system for water treatment, disinfection of the hemodialysis system and microbiological monitoring of the water and dialysate are necessary.
Laboratoire de Microbiologie, Faculté de médecine et de pharmacie, Université Sidi Mohammed Ben Abdallah, Fès, Maroc.
Bouchra
B
Oumokhtar
Laboratoire de Diagnostic épidémiologique et d'hygiène du milieu. Direction régionale de la santé, Fès, Maroc.
Abdelhakim El Ouali
Ael O
Lalami
Laboratoire de Microbiologie, Faculté de médecine et de pharmacie, Université Sidi Mohammed Ben Abdallah, Fès, Maroc.
Mustapha
M
Mahmoud
Laboratoire de Diagnostic épidémiologique et d'hygiène du milieu. Direction régionale de la santé, Fès, Maroc.
Sanae
S
Berrada
Service de néphrologie, CHU Hassan II, Faculté de médecine et de pharmacie, Université Sidi Mohammed Ben Abdallah, Fès, Maroc.
Mohammed
M
Arrayhani
Service de néphrologie, CHU Hassan II, Faculté de médecine et de pharmacie, Université Sidi Mohammed Ben Abdallah, Fès, Maroc.
Tarik Squalli
TS
Houssaini
D001419:Bacteria / Q000302:isolation & purification; D004203:Disinfection / Q000379:methods / Q000592:standards; D004352:Drug Resistance, Microbial; D006801:Humans; D017053:Infection Control / Q000379:methods*; D009018:Morocco; D006435:Renal Dialysis / Q000592:standards*; D014867:Water / Q000592:standards; D014871:Water Microbiology; D018508:Water Purification / Q000592:standards; D014881:Water Supply / Q000592:standards*
D014867:Water
Dialysate; Hemodialysis; Water; antibiotic resistance; disinfection; microbial contamination