Large scale production of sterile, distilled water for hospital dialysis. Description of equipment and evaluation of the water quality

Bacteriological and clinical evaluation of different dialysate delivery systems

In the period 1964-74 four different dialysate delivery systems have been used in our department. 1) Central mixing of dialysate using tap water and a dialysate delivery line with "dead ends" resulting in stagnant dialysate. 2) Central mixing of dialysate with cold distilled water, otherwise equal to system 1. 3) Local mixing of dialysate with cold distilled water, delivered through a line with "dead ends" resulting in stagnant water. 4) Local mixing of dialysate with distilled water, cooled to 25 degrees C just prior to use, reduced "dead ends" and monitored constant overflow to drain through the water supply line. The bacterial contamination of the four systems was examined and related to the clinical occurrence of pyrogenic and other reactions. An improvement was noted with the change from central to local mixing of dialysate (system 3) but complete sterility and virtual freedom from clinical reactions were first obtained in system 4. It is concluded that the use of sterile or near sterile dialysate is recommendable.

Photoreactivation of Pseudomonas cepacia after ultraviolet exposure: a potential source of contamination in ultraviolet-treated waters

Cells of a naturally occurring strain of Pseudomonas cepacia grown in distilled water were exposed to ultraviolet radiation. Irradiated samples incubated on membrane filters or in fluid recovery media in the absence of light showed no evidence of dark repair mechanisms. When samples were exposed to fluorescent light ranging from 50 to 950 foot candles (538 to 10,222 lux) of illumination, apparent photo-induced repair of ultraviolet injury resulted in 1- to 4-log increases in viable cells recovered.