title: Microbiological qualification of air, water and dialysate in a haemodialysis centre: a new focus onLegionellaspp.
abstract: OBJECTIVE
  The microbiological monitoring of the water used for haemodialysis is important especially forLegionellaand non-fermentative bacteria since patients with end stage renal disease (ESRD) are suffering from deteriorated function of immune system.
  
  
  METHODS
  A total 50 water and dialysate samples were weekly collected over a period of 10 weeks from 5 sites. Total and faecal coliforms were determined by utilizing the most probable number (MPN) method. For isolation ofLegionella,water samples were inoculated on a BCYE medium. DNA extraction was performed and was used to amplify16S rRNAgene ofLegionellaspecies. Airborne bacteria were sampled using a single stage Andersen air sampler.
  
  
  RESULTS
  Out of total 50 water samples, 24 samples had bacterial contamination. The highest rate ofLegionellacontamination was observed in the storage tank (67 cfu/ml).Legionellawas not isolated from the dialysate effluent samples. The highest rate of total bacterial count was related to the dialysate effluent and the maximum total count of coliforms was related to the reverse osmosis. The isolated bacteria were Gram-negative bacilli (mostlyPseudomonasisolates), Gram-positive cocci (mostlyMicrococcus spp.) and Gram-positive bacilli (mostlyBacillus spp.). Six samples were contaminated with coliforms. No faecal coliform was isolated from the samples.
  
  
  CONCLUSIONS
  These results indicated that dialysis machine is an important source of contaminations such asStaphylococcus, PseudomonasandLegionella.Therefore an efficient prevention program is needed to eliminate bacterial contamination of dialysis water system. Moreover, in haemodialysis centres, periodic surveillance programs for microbiological qualification can lead to a better planning for disinfection of haemodialysis water systems.
authors.affiliation: Department of Environmental Health Engineering, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran.
authors.forename: Saeid
authors.initials: S
authors.lastname: Nazemi
authors.affiliation: School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Mirzaii
authors.affiliation: Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, karaj, Iran.
authors.forename: Somayeh
authors.initials: S
authors.lastname: Yaslianifard
authors.affiliation: Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Davood
authors.initials: D
authors.lastname: Darban-Sarokhalil
authors.affiliation: Medicinal Plant Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.
authors.forename: Seyyed Sajjad
authors.initials: SS
authors.lastname: Khoramrooz
authors.affiliation: School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran.
authors.forename: Pirasteh
authors.initials: P
authors.lastname: Norozi
authors.affiliation: School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Davardoost
keywords: Haemodialysis; Legionella; Microbiological qualification