Disinfection of the peritoneal dialysis bag medication port: Comparison of disinfectant agent and disinfection time.

AIM: The aim of the present study was to compare different disinfection techniques for the peritoneal dialysis bag medication port (MP). METHODS: An experimental study was conducted testing different cleaning agents (70% alcohol vs 2% chlorhexidine) and time periods (5, 10 and 60 s) for disinfection of the MP. Five microorganisms (S. aureus, E. coli, A. baumannii and C. parapsilosis, CNS) were prepared for use as contaminants of the MP. MP were incubated in Tryptic soy broth at 36°C for 24 h, after which, they were seeded on a Biomérieux blood agar plate and incubated for 24 h at 36°C. RESULTS: Three hundred peritoneal dialysis bags were analyzed regarding the time expose to the disinfectant showed a statistically significant difference in the number of culture positive (7/100) P = 0.001; Gram positive (6/100) P = 0.006 for 5 s, one positive culture and turbid bag with 10 s, while friction for 60 s showed all negative results. The comparison between disinfectant, alcohol or chlorhexidine, 150 bag in each group, showed that the ones disinfected with alcohol had five turbid bags, eight positive cultures and seven germs identified, while all bags disinfected with chlorhexidine were negative for all parameters, with a difference statistically significant (P = 0.004). CONCLUSION: Our results suggest that the MP should be scrubbed with 2% chlorhexidine for at least 5 s; if alcohol 70% is used the length of friction should not be inferior to 10 s.

Time to Positivity of Bacteria Cultures in Peritoneal Dialysis Fluid: Evaluation of Different Laboratory Techniques.

Patients with chronic kidney disease on peritoneal dialysis (PD) are susceptible to infections, with peritonitis being the primary cause of dropout. Peritoneal fluid culture is one of the essential elements for proper diagnosis and peritonitis treatment. The aim of this study was to compare the time required to obtain a positive culture using different laboratory methods. An in vitro cross-sectional study was conducted comparing different techniques for preparation and culture of bacteria in peritoneal fluid. The research was carried out with 21 sterile dialysis bags and 21 PD bags containing peritoneal fluid drained from patients without peritonitis. Fluids from the 42 PD bags were contaminated by injecting a coagulase-negative Staphylococcus suspension and then prepared for culture using 4 distinct techniques: A - direct culture; B - post-centrifugation culture; C - direct culture after 4 h sedimentation; and D - culture after 4 h sedimentation and centrifugation. This was followed by seeding. In the 21 contaminated sterile bags, mean times to obtain a positive culture with techniques D (19.6 h ± 2.6) and C (19.1 h ± 2.3) were longer than with technique A (15.8 h ± 3.0; p < 0.01), but not statistically different from group B (19.0 h ± 3.2). The same occurred in the 21 bags drained from patients, with mean times for techniques D (14.0 h ± 1.9) and C (14.5 h ± 1.7) being longer than technique A (12.22 h ± 1.94; p < 0.05) but not statistically different from technique B (13.2 h ± 1.3). The sedimentation and centrifugation steps seem to be unnecessary and may delay antibiotic sensitivity test results by approximately 8 hours.