High level of recovery of fungi from water and dialysate in haemodialysis units

The counts of yeasts and filamentous fungi were investigated in the municipal water supplies of haemodialysis centres, in the treated water and the dialysate from all 85 haemodialysis units in Greece, in order to estimate their occurrence, their correlation with contamination indicator bacteria and other influencing factors. Filamentous fungi and yeasts were isolated from 69 (81.2%) and from three (3.5%) feed water samples, from 74 (87.1%) and seven (8.2%) treated water samples and from 66 (77.7%) and 11 (12.9%) dialysate samples respectively. Aspergillus spp and Penicillium spp were the most frequent moulds, while Candida spp were the prevailing yeasts. The occurrence of yeasts was significantly higher in dialysate than in tap water samples. Counts of filamentous fungi in all 255 samples were significantly correlated with the counts of total heterotrophic bacteria and enterococci, whereas the counts of yeasts were correlated with faecal coliforms, total heterotrophic bacteria, as well as enterococci, Pseudomonas spp and total coliforms, while no correlation was detected with the age of either haemodialysis units, the age of water treatment system, the number of artificial kidney machines or the components of the water purification system. High recovery of fungi from haemodialysis aqueous environments implies a potential risk for haemodialysis patients and indicates the need for continuous maintenance and monitoring.