Pseudomonas aeruginosa bacteremia in a dialysis unit. 1. Recognition of cases, epidemiologic studies and attempts at control.

Infections commonly occur in patients undergoing dialysis and have been related to diminished host resistance of uremic patients, the arteriovenous fistulas and bacteriologic contamination of dialysis fluids. The occurrence of four cases of bacteremia due to Pseudomonas, three of which were type 7, and the presence of this serotype in the dialysis fluids suggested an important association between infection and growth of bacteria in the fluids. Attempts to reduce levels of bacteria in the dialysis fluid were unsuccessful using dialysate free of glucose in clinical trial, despite in vitro studies demonstrating poor growth of Pseudomonas in this medium. A filter placed with the recirculating system was only partially successful. The second paper of this series traces the portal of entry of bacteria from dialysate to the blood through reutilized coils.