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Fluids for continuous renal replacement therapy - an evaluation of microbial integrity

Lookup NU author(s): Dr Suren Kanagasundaram, Dr John Perry, Dr Nicholas Hoenich, Dr Rachael Fraser

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Abstract

Purpose: 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 degrees 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 trisodium 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.

Publication metadata

Author(s): Kanagasundaram NS, Perry JD, Hoenich NA, Clark RA, Fraser RA, Walton KE

Publication type: Article

Publication status: Published

Journal: International Journal of Artificial Organs

Year: 2015

Volume: 38

Issue: 1

Pages: 13-16

Print publication date: 04/02/2015

Online publication date: 23/01/2015

Acceptance date: 14/12/2014

ISSN (print): 0391-3988

ISSN (electronic): 1724-6040

Publisher: Wichtig Publishing

URL: http://dx.doi.org/10.5301/ijao.5000378

DOI: 10.5301/ijao.5000378

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