title: Fluids for continuous renal replacement therapy--an evaluation of microbial integrity.
abstract: OBJECTIVE
  We have previously demonstrated widespread microbial contamination in the dialysis and replacement fluid circuits of bicarbonate-buffered, continuous renal replacement therapies (CRRTs). It is not known whether different CRRT fluids have an impact on bacterial activity.
  
  
  METHODS
  In this study the in vitro growth and biofilm formation associated with seven strains of bacteria (Burkholderia cepacia, Escherichia coli, Staphylococcus aureus, Stenotrophomonas maltophilia, Pseudomonas aeruginosa, Pseudomonas fluorescens, and Staphylococcus epidermidis) in five CRRT fluids (Prismocitrate, Monosol S, Accusol 35, tri-sodium citrate and Ci-Ca K2) were studied. The fluids were each inoculated with light and heavy concentrations of each of the bacterial strains and incubated at 22 or 37°C for up to 72 h with and without bacterial growth medium. Bacterial growth was assessed by spectrophotometry. Biofilm formation was assessed by a standard microtiter plate assay.
  
  
  RESULTS
  Unsupplemented fluids did not support bacterial growth or biofilm formation after 72 h incubation. When supplemented with bacterial growth medium, some fluids, in particular Accusol 35, Ci-Ca K2, and tri-sodium citrate, had an inhibitory effect on bacterial growth, although none suppressed growths across the panel of tested organisms.
  
  
  CONCLUSIONS
  Different CRRT fluids have different impacts on bacterial growth and biofilm formation, but all remain susceptible to extrinsic contamination.
authors: 2 Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne - UK.
authors: Nigel S
authors: NS
authors: Kanagasundaram
authors: John D
authors: JD
authors: Perry
authors: Nicholas A
authors: NA
authors: Hoenich
authors: Rauri A
authors: RA
authors: Clark
authors: Rachel A
authors: RA
authors: Fraser
authors: Katherine E
authors: KE
authors: Walton
mesh_terms: D018441:Biofilms / Q000254:growth & development*; D003470:Culture Media; D004866:Equipment Contamination; D006090:Gram-Negative Bacteria / Q000254:growth & development* / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000254:growth & development* / Q000302:isolation & purification; D015312:Hemodialysis Solutions; D006801:Humans; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods; D012494:Sampling Studies
chemical_list: D003470:Culture Media; D015312:Hemodialysis Solutions