Biofilms invade nephrology: Effects in hemodialysis

Bacteria attach to surfaces and aggregate in a biopolymer matrix to form bi ofilm. Studies on biofilm have shown its presence in many prosthetic device s used in nephrology as well as in fluid pathways of hemodialysis plants an d monitors. Once present, this community of bacteria increases resistance t o biocide due to slime production and, as a result, chemical products for d ialysis monitor disinfection and descaling procedures do not result in an e ffective treatment. Ultrapure dialysate is a goal in modern hemodialysis, a nd ultrafiltration is used to obtain sterile and apyrogen fluids. Microbial colonisation of ultrafilters may occur if, due to inadequate disinfection protocols, membrane is exposed to persistent bacterial contamination, and b iofilm is allowed to form and to grow. As more and more data link final dia lysate microbial contamination to clinical effects of bioincompatibility fr om chronic inflammation in dialysis patients, attention has to be focused o n possibilities of biofilm avoidance. Copyright (C) 2000 S. Karger AG, Base l.