DIALYSATE BACTERIOLOGICAL QUALITY IN A HEALTH DISTRICT
CALIDAD BACTERIOLÓGICA DEL DIALIZADO EN UN ÁREA SANITARIA
José María Lamas Barreiro Nefrología Hospital Meixoeiro. CHUVI, Mario Alonso Suárez Nefrología Hospital Meixoeiro. CHUVI, Fernándo Sastre Fernández Ne
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CHUVI, Mario Alonso Suárez Nefrología Hospital Meixoeiro. CHUVI, Fernándo Sastre Fernández Ne" "autores" => array:1 [ 0 => array:1 [ "nombre" => "José María Lamas Barreiro Nefrología Hospital Meixoeiro. CHUVI, Mario Alonso Suárez Nefrología Hospital Meixoeiro. CHUVI, Fernándo Sastre Fernández Ne" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "CALIDAD BACTERIOLÓGICA DEL DIALIZADO EN UN ÁREA SANITARIA" ] ] "pdfFichero" => "P-E-S-A4388-EN.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec436363" "palabras" => array:1 [ 0 => "Dializado, endotoxinas, hemodiálisis" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec436364" "palabras" => array:1 [ 0 => "Dialysate, endotoxins, haemodialysis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "Background: There is a serious lack of data in literature on the quality of dialysate used in haemodialysis units throughout Spain and there also exist discrepancies between clinical guides on criteria related to dialysate bacteriological quality. Aim: Ascertain bacteriological quality of dialysate used in our area. Materials and methods: Descriptive observational studies were carried out monthly and over a period of one year, at two haemodialysis units (unit A: third level public hospital using Monitral®-Hospal monitors and unit B: state subsidised non-profit organisation using AK90®-Gambro monitors. Tests were performed to determine cultures and endotoxins in water treated with reverse osmosis and in the dialysate. Results are expressed as means (range) and as percentage samples that comply with or deviate from the 2004 recommendations of the Association for Advancement of Medical Instrumentation. Results: Cultures showed 7 (0-53), 100% <200 and 5 0-50 100 <200 cfu ml in water treated with reverse osmosis and values of 226 0-1000 58 <200 and 75 0-800 92 <200 cfu ml were obtained in dialysate from units a and b respectively endotoxins levels 0 07 05-0 15 100 <0 25 and 0 34 06-1 16 70 <0 25 ue ml in water treated with reverse osmosis and 725 72 1 83-2 645 90 2 and 16 (0,05-60,87), 70%>2, UE/ml in dialysate from units A and B, respectively. Conclusions: Water treated with reverse osmosis at both units shows good compliance of bacteriological criteria and an acceptable level of endotoxins. The dialysate shows good compliance of bacteriological criteria at unit B and inadequate compliance for unit A. Poor compliance of endotoxins criteria was observed especially in the case of unit A. It would be interesting to have published data on endotoxins levels in dialysate from other dialysis units in Spain, to know if it is possible to achieve the bacteriological quality recommended by the guides using the actual HD monitors without filters for the dialysate and to evaluate from the clinical point of view the utility and efficiency of these filters in conventional HD. </0> </0> </200> </200> </200> </200>" ] "es" => array:1 [ "resumen" => "Antecedentes: Existen discrepancias entre las guías clínicas sobre los criterios de calidad bacteriológica del dializado y no hay datos en la literatura sobre la calidad del dializado utilizado en las unidades de hemodiálisis de nuestro país. Objetivo: Conocer la calidad bacteriológica del dializado utilizado en nuestro entorno. Material y métodos: Estudio observacional descriptivo en dos unidades de hemodiálisis (unidad A: hospital público de tercer nivel con monitores Monitral®-Hospal y unidad B: centro concertado de una fundación sin ánimo de lucro con monitores AK90®-Gambro, realizando mensualmente, durante un año, cultivos y determinación de endotoxinas en el agua tratada con ósmosis inversa y en el dializado. Los resultados se expresan como media (rango) y como porcentaje de muestras que cumplen o se desvían de las recomendaciones de la Association for Advancement of Medical Instrumentation (AAMI) de 2004. Resultados: Los cultivos mostraron 7 (0-53), 100% <200 y 5 0-50 100 <200 ufc ml en el agua con ósmosis inversa y 226 0-1000 58 <200 y 75 0-800 92 <200 ufc ml en el dializado de las unidades a y b respectívamente los niveles endotoxinas fueron 0 07 05-0 15 100 <0 25 y 0 34 06-1 16 70 <0 25 ue ml en el agua con ósmosis inversa y 725 72 1 83-2 645 90 2 y 16 (0,05-60,87), 70%>2, UE/ml en el dializado de las unidades A y B, respectívamente. Conclusiones: El agua tratada con ósmosis inversa de ambas unidades muestra un buen cumplimiento de los criterios bacteriológicos y aceptable de los criterios sobre nivel de endotoxinas. El dializado muestra un buen cumplimiento de los criterios bacteriológicos en la unidad B e inadecuado en la unidad A y un escaso cumplimiento de los criterios de endotoxinas, sobre todo en la unidad A. Sería de interés disponer de datos publicados sobre el nivel de endotoxinas en el dializado de las unidades de diálisis de nuestro país, conocer si es posible conseguir la calidad bacteriológica recomendada por las guías con los monitores actuales de HD sin utilizar filtros para el dializado y evaluar desde el punto de vista clínico la utilidad y eficiencia de estos filtros en HD convencional. </0> </0> </200> </200> </200> </200>" ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000002700000002/v0_201502091552/X2013251407021108/v0_201502091552/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/20132514/0000002700000002/v0_201502091552/X2013251407021108/v0_201502091552/en/P-E-S-A4388-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251407021108?idApp=UINPBA000064" ]
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