Provincial Diagnostic Laboratory Epidemiological and Environmental Health, Provincial Health Delegation, Mohammedia, Morocco E-mail:
Laboratory of Microbiology and Molecular Biology, UATRS-PGF, National Center for Scientific and Technical Research, Rabat, Morocco.
J Water Health. 2022 Feb;20(2):441-449. doi: 10.2166/wh.2022.267.
The water treatment process is a vital factor for hemodialysis (HD) patients. This study aimed to assess the degree of contamination of HD water by bacteria at the HD center of Mohammedia, Morocco, in addition to evaluating the antimicrobial resistance of isolated bacteria. Fifty-four water samples were taken, the appropriate cultures were used to isolate the pathogenic bacteria, which were identified biochemically and molecularly by 16S RNA sequencing. Their susceptibility to antimicrobial drugs was determined by the disk diffusion method. Approximately 5.5% of water samples were above the norm. The isolated bacteria that colonized the HD systems were mostly Gram-negative bacilli, such as Stenotrophomonas maltophilia, Pseudomonas spp., and Burkholderia cepacian. Results of the antibiotics test showed remarkable resistance levels. Among Pseudomonas spp. and S. maltophilia, 10 strains were classified as multidrug-resistant (MDR), and 4 as extensively drug-resistant (XDR). The diversity of bacterial strains isolated in the water used for HD treatments, and their worrying resistance levels pose a significant risk to patients. For these reasons, an urgent need for periodic microbiological monitoring of water after each treatment step must be applied, and the treatment process should also be optimized.
水处理过程是血液透析（HD）患者的一个重要因素。本研究旨在评估摩洛哥莫哈默迪亚 HD 中心 HD 水中细菌的污染程度，此外还评估了分离细菌的抗菌药物耐药性。采集了 54 个水样，使用适当的培养物分离出病原菌，通过 16S RNA 测序进行生化和分子鉴定。采用纸片扩散法测定其对抗菌药物的敏感性。约 5.5%的水样超过了标准。定植在 HD 系统中的分离细菌主要是革兰氏阴性杆菌，如嗜麦芽寡养单胞菌、假单胞菌和洋葱伯克霍尔德菌。抗生素试验结果显示出显著的耐药水平。在假单胞菌和嗜麦芽寡养单胞菌中，有 10 株被归类为多药耐药（MDR），4 株为广泛耐药（XDR）。从用于 HD 治疗的水中分离出的细菌菌株的多样性及其令人担忧的耐药水平对患者构成重大风险。出于这些原因，必须对每个治疗步骤后的水进行定期微生物监测，并且还应优化治疗过程。
