Outbreaks of infection and/or pyrogenic reactions in dialysis patients.

These dialysis-related outbreaks demonstrate the ongoing potential for infection-related morbidity and mortality among dialysis patients. Many of these outbreaks could have been prevented by adequate water treatment, proper disinfection of water systems and dialysis machines, adherence to recommended reprocessing protocols in centers reusing dialyzers, and more stringent quality control monitoring. Finally, these outbreaks highlight the importance of active surveillance for adverse events among dialysis patients. The incidence of gram-negative bacteremia, pyrogenic reactions, and peritonitis should be monitored over time and any increase in incidence investigated.