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2016 ; 8
(5
): e39332
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Efficacy of Biofilm Removal From Hemodialysis Piping
#MMPMID27878114
Isakozawa Y
; Migita H
; Takesawa S
Nephrourol Mon
2016[Sep]; 8
(5
): e39332
PMID27878114
show ga
BACKGROUND: Central dialysate fluid delivery systems (CDDS) are used by dialysis
centers in Japan, and although these systems are effective at delivering
dialysate, they have a complex piping network with numerous sites where
contamination can develop. In Japan, cleaning disinfectants have been clinically
evaluated based on endotoxin levels and bacterial counts, but there have been no
published studies evaluating the biofilm removal efficacy of these agents at the
electron microscope level. OBJECTIVES: In this study, we used electron microscopy
to evaluate the effectiveness of various cleaning disinfectants in removing
biofilms from hemodialysis piping. METHODS: Liquid nitrogen was used to sever a
section of dialysis piping on which a biofilm had formed during clinical use.
Sodium hypochlorite, acetic acid, and peracetic acid were used at stock-solution
concentrations as cleaning disinfectants. These disinfectants were tested at room
temperature and when heated (80°C). After cleaning and disinfection, biofilm
removal from the surface of the piping was evaluated using a scanning electron
microscope (SEM). RESULTS: Sodium hypochlorite did not show good biofilm removal
at room temperature or when heated. Acetic acid was more effective at biofilm
removal when heated than at room temperature. Peracetic acid was highly effective
at biofilm removal at both room temperature and when heated. CONCLUSIONS:
Cleaning and disinfection using a disinfectant at a high temperature and high
concentration effectively removes biofilms from hemodialysis piping. However,
long-term exposure to disinfectants may affect the piping material.