WATER QUALITY ASSESSMENT ASSOCIATED WITH HEMODIALYSIS SYSTEMS.

Name: Yohanna Mayelle Gomes
Type: PhD thesis
Publication date: 12/02/2020
Advisor:

Namesort descending Role
Sérvio Túlio Alves Cassini Advisor *

Examining board:

Namesort descending Role
Antonio Sérgio Ferreira Mendonça Internal Examiner *
Kênia Valéria dos Santos External Examiner *
Ricardo Franci Gonçalves Internal Examiner *
Ricardo Pinto Schuenck External Examiner *
Sérvio Túlio Alves Cassini Advisor *

Summary: The objective of the research was to characterize the water quality for hemodialysis and
to describe microorganisms present in the water. Ion chromatography methodologies
were used to determine nutrient concentration in water, Elisa for microcystins detection,
MALD-TOF MS for identification of isolated microorganisms, antibiogram test discs
and minimum inhibitory concentration, action of disinfectants (UV, hypochlorite of
sodium and peracetic acid) and metagenomic analysis to characterize the bacterial
community present in the water treatment system. It was identified that the levels of
nitrate, fluoride and BHT found may present a risk to the patient on hemodialysis. In a
drinking water sample the presence of microcystin was verified. Of the isolates,
Ralstonia sp. was the most frequent. About 60% of the isolated bacteria showed a
pattern of multidrug resistance to antimicrobials, mainly colistin, gentamicin and
carbapenemics. The water treatment system was able to remove 95% of the gene
sequences detected in the incoming water. The most prevalent species were
Sphingomonas alpina, Curvibacter gracilis, Bradyrhizobium sp., Ralstonia picketti,
Escherichia coli, Serratia liquefaciens and Serratia proteamaculans. The presence of
emerging pathogenic bacteria and multiresistance profiles detected in this study indicate
the need for microbiological monitoring of water for hemodialysis.

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