3 kidney patients developed infections at L.A. dialysis center

Three patients at a Los Angeles County dialysis center developed serious infections last summer because of improper cleaning and disinfection of a reusable medical device called a dialyzer, researchers reported Tuesday. The dialyzer -- in effect, an artificial kidney -- removes toxic substances from the blood in patients whose own kidneys are not functioning. All three infections were traced to one machine, and the center has decided to stop using that type of machine, which is more difficult to disinfect than others.

The infections were reproted to the L.A. County health department in August by a hospital where all three patients were treated. Two of the patients had developed fevers and were hospitalized. The third was treated as an outpatient. All the patients recovered.

Public health nurse L’Tanya English investigated the outbreak and reported at a San Antonio meeting of the Assn. for Professionals in Infection Control and Epidemiology that the bacteria infecting the three patients were genetically linked. All were infected with Stenotrophomonas maltophilia, a rare type of gram-negative bacteria. Two of the patients were also infected with Candida parapsilosis, a fungus that can cause sepsis in immunocompromised patients. That same fungus was found on a door handle in the room where the dialyzers were cleaned and disinfected.

Dialysis always carries a high risk of infection, English said, because blood is pumped through the dialyzers. It is especially problematic in those dialyzers that must be taken apart to be cleaned.

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