Kanamori Hajime, Weber David J, Flythe Jennifer E, Rutala William A
Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Open Forum Infect Dis. 2022 Feb 3;9(3):ofac058. doi: 10.1093/ofid/ofac058. eCollection 2022 Mar.
Individuals treated with dialysis are at high risk for healthcare-associated infections. We conducted a literature review of outbreaks associated with water in hemodialysis during years 2011-2021 to understand the role of water as a source of infections for patients receiving hemodialysis with a focus on the risks associated with dialysis water and dialysate. For dialysis patients, water and dialysate have been a source of healthcare-associated pathogens, including nontuberculous mycobacteria and gram-negative bacilli as well as systemic reactions due to gram-negative bacilli-associated endotoxin. Lapses in infection prevention practices and dialysis water management were primarily involved in waterborne outbreaks. Dialysis clinics should adhere to recommendations regarding monitoring and levels of bacteria and endotoxin in hemodialysis water and dialysate. Since hemodialysis patients are at increased risk of healthcare-associated infections, it is important for healthcare personnel to adhere to infection prevention guidelines in hemodialysis patient care, especially hand hygiene, aseptic technique, cleaning/disinfection, and water management.
接受透析治疗的个体发生医疗保健相关感染的风险很高。我们对2011年至2021年期间与血液透析用水相关的疫情进行了文献综述，以了解水作为接受血液透析患者感染源的作用，重点关注与透析用水和透析液相关的风险。对于透析患者而言，水和透析液一直是医疗保健相关病原体的来源，包括非结核分枝杆菌和革兰氏阴性杆菌，以及由革兰氏阴性杆菌相关内毒素引起的全身反应。感染预防措施和透析用水管理方面的失误主要与水源性疫情有关。透析诊所应遵循有关监测以及血液透析用水和透析液中细菌和内毒素水平的建议。由于血液透析患者发生医疗保健相关感染的风险增加，医护人员在血液透析患者护理中遵循感染预防指南非常重要，尤其是手部卫生、无菌技术、清洁/消毒和用水管理。
