Has anyone experienced high dialysate cultures on the K machines? Our waters are good just problems with dialysate cultures. We have done end to end disinfection several times. No diasafe filters, doing daily bleach and heat disinfection.

lady tech, make sure that you are not having any cross contamination from the drain board/priming buckets. Any blood or fluid that may get behind the collars/sleeves on the red and blue dialyzer connectors, make sure that the staff are cleaning those well..Hope that helps, FYI...

Did the problem just suddenly occur? Has anything else changed, such as the person who draws cultures or change in technique?

How high are the results?

Have you cultured your bicarbonate mixer, loop or jugs?

We have the same tech draw the cultures monthly. The bicarb and water cultrues are good. There does not appear to be any cross contamination.

when are you pulling your cultures in respect to the disinfections? You may want to try to draw both pre and post disinfection samples to see if there is any difference (possible biofilm probelm).
Also are you doing the cultures in house or sending to lab. Certain times of year you have to make sure that the samples are packed adequately (although that would not explain some high and others not unless they were handled differently).
When you are doing end to end disinfection is everything being turned on (equipment wise) and put through rinse to disinfect incoming water line.

The weather will affect fluids in different ways. The heat will increase all bacterial growth but the dialysate has a better nutritional environment for bacteria. Water has little nutrient and the bicarb conc. is too salty for some bacteria.

lady tech,
Are you collecting the samples directly from the Hansen connector?

pato

We had a similar problem. We found out it was the machine itself. There is a small portion of the machine at the begining of the hydraulics that doesn't get disinfected with a heat or a bleach. We solved our bacterial headache by disinfecting the water loop and running the disinfectent into the machine via the water hose.

Have you checked the hose between the water loop and the dialysis machine. Normally, a diasafe filter would remove any contamination from the inlet hose. Does your loop disinfection include the connection to the dialysis machine? Have you replaced your inlet hose recently?

Thanks for the suggestions. We have disinfected the loop and have drawn the disinfectent into the machine to dwell overnight. We have disinfected the water lines on the machines several times. We still continue to have problems. We continue with daily bleach and heat disinfectionn

Do you collect the dialysate samples straight from the blue Hansen connector?

pato

We collect the outflow from the top port of the dialyzer.

What strength disinfectant are you using that you can allow it to dwell overnight? I am wondering if it too weak? We use 1% bleach, and Fresenius advised not letting dwell more than one hour.