La sorveglianza del rischio infettivo in emodialisi: esperienza nell’Azienda Ospedaliera Umberto I Ancona.

Inlections surveillance represents the basis of every programme of prevention: the collection and analysis of data allow the individuation of risks factors. This monitoring is foremost unavoidable if considering the impaired state of immunity typical of the ESRD patient. According to SIN data, the 7% of deaths among patients undergoing haemodialysis is caused by infections. The microbiological contamination 0f dialysis fluids is a demonstrated cause of different acute and chronic troubles, such as: pyrogenic reactions, shock, osteoporosis, carpal tunnel syndrome, amyloidosis. From 1992, the Service of Hospital Hygiene of the "Umberto l'' hospital of Ancona carries out microbiological controls of specimens coming from the water treatment system and from the dialysis monitors; since October 2001 the LAL test technique (gel-clot method) for the detection of bacterial endotoxins has been introduced. The low number of unacceptable specimens in this decade of surveillance indicates the efficacy of hygienic management of the system and the effectiveness of all involved staff efforts.