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< Vol. 38 Issue 1 (January 2015)

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

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

Int J Artif Organs 2015; 38(1): 13 - 16

Article Type: ORIGINAL ARTICLE

Article Subject: Artificial kidney, apheresis and detoxification techniques

DOI:10.5301/ijao.5000378

Authors

Nigel S Kanagasundaram, John D Perry, Nicholas A Hoenich, Rauri A Clark, Rachel A Fraser, Katherine E Walton

Corresponding author

  • Nigel S Kanagasundaram
  • Renal ServicesFreeman Hospital
  • >Newcastle upon Tyne NE7 7DN, UK
  • [email protected]

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°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.

Article History

  • • Accepted on 14/12/2014
  • • Available online on 23/01/2015
  • • Published in print on 04/02/2015

Disclosures

Financial support: Financial support for all consumables was provided by The Northern Counties Kidney Research Fund, Newcastle upon Tyne, UK.
Conflict of interest: None of the authors have any interests to disclose and there are no conflicts of interest.
Meeting presentations: The results of this study were presented in poster format at the American Society of Nephrology annual meeting, San Diego, October 27 to November 1, 2009.

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Authors

  • Kanagasundaram, Nigel S [PubMed] [Google Scholar] 1, 2, * Corresponding Author ([email protected])
  • Perry, John D [PubMed] [Google Scholar] 3
  • Hoenich, Nicholas A [PubMed] [Google Scholar] 1
  • Clark, Rauri A [PubMed] [Google Scholar] 1
  • Fraser, Rachel A [PubMed] [Google Scholar] 4
  • Walton, Katherine E [PubMed] [Google Scholar] 3

Affiliations

  • Renal Services, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne - UK
  • Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne - UK
  • Department of Microbiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne - UK
  • Department of Pharmacy, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne - UK

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