title: Bacteriological Quality of Treated Water and Dialysate in Haemodialysis Unit of A Tertiary Care Hospital.
abstract: BACKGROUND
  Haemodialysis is one of the treatment modalities for patients suffering from end stage renal disease (ESRD). Dialysis patients are exposed to large volumes of water for production of dialysis fluids. Treated water and dialysate come in direct contact with the patient's bloodstream. Such patients suffer from abnormalities of the immune system, making them more susceptible to infections. Microbial contamination of the treated water and dialysate can lead to biofilm formation and release of endotoxins in Haemodialysis system. These can give rise to pyrogenic reactions in the short term and β2 amyloidosis, atherosclerosis, and increased mortality in the long term.
  
  
  OBJECTIVE
  To assess the bacteriological quality of treated water and dialysate used in the Haemodialysis unit of a tertiary care hospital.
  
  
  METHODS
  A retrospective review of records of treated water and dialysate samples sent to the Microbiology laboratory for analysis of bacteriological contamination of the water used in haemodialysis treatment from January 2013 to June 2014 was conducted. The acceptable limits for treated water and dialysate were taken as <200 CFU/ml and < 2000 CFU/ml respectively as per Government of India Guidelines for Maintenance Haemodialysis.
  
  
  RESULTS
  Thirty six samples of treated water and 394 samples of dialysate were analysed for bacteriological contamination. 4 out of 36 (11.1%) samples of treated water and 44 out of 394 dialysate samples (11.2%) showed unacceptable bacteriological growth.
  
  
  CONCLUSIONS
  Regular and continual monitoring of the disinfection protocol of the water distribution system in haemodialysis unit is necessary to get good microbiological quality of treated water and dialysate fluid.
authors.affiliation: Post Graduate, Department of Microbiology, M.S. Ramaiah Medical College , Bangalore, Karnataka, India .
authors.forename: Shiva
authors.initials: S
authors.lastname: Verma
authors.affiliation: Professor, Department of Microbiology, M.S. Ramaiah Medical College , Bangalore, Karnataka, India .
authors.forename: V A
authors.initials: VA
authors.lastname: Indumathi
authors.affiliation: Professor, Department of Nephrology, M.S. Ramaiah Medical College , Bangalore, Karnataka, India .
authors.forename: K C
authors.initials: KC
authors.lastname: Gurudev
authors.affiliation: Associate Professor, Department of Microbiology, M.S. Ramaiah Medical College , Bangalore, Karnataka, India .
authors.forename: Shalini Ashok
authors.initials: SA
authors.lastname: Naik
keywords: Dialysis fluid quality; Microbiological contamination; Water treatment