baxter ARENA - Culture Sampling; Disinfection Verification; Water Supply Sample Collection

Arena Service Manual
9.10 DISINFECTION VERIFICATION
9.10.1 Culture Sampling
The bacteriologic test is a quantitative test and not a qualitative test
(AAMI, 1990, pp. 81-94). We need to know the total amount of
bacteria present in the water or the hemodialysis system.
Disinfection procedures discussed in this section deal only with the
presence of bacteria over the maximum allowable limits in water
or dialysate, not with the types of bacteria present.
The Association for the Advancement of Medical Instrumentation
(AAMI) recommends monthly sampling of the water treatment
system or when clinical indications suggest pyrogenic reactions
and/or septicemia (AAMI, 1990, pp. 55-58). If previous test
results exceed maximum limits or there have been changes in the
disinfection procedures, samples should be repeated (AAMI, 1990,
pp. 81-94).
Initial water samples should be taken at a point where it enters a
proportioner (AAMI, 1990, pp. 81-94) or just before it enters a
Baxter hemodialysis system. This ensures all upstream
components of the water system be considered as areas where
bacteria may be growing. Samples taken before this point may not
show a contamination if only the feed line to the machine was the
source of the bacteria.
Samples should be taken at each supply point throughout the water
distribution system to assure complete sampling. This is
particularly true if patients are displaying pyrogenic reactions,
disinfection procedures have changed, or previous samples were
outside acceptable limits.
9.10.1.1 Water Supply Sample Collection
1. Attach a clean (see Note 1) 1/4" ID hose to the water
supply.
2. Open the water supply at full force and do a high velocity
flush of the hose for about 1 minute.
3. Reduce flow to a controllable flow rate.
4. Using aseptic technique, draw a clean sample into an
appropriate, clean container (see Note 2). Seal the
container immediately after taking the sample.
5. Wipe the exterior of the container with an alcohol swab.
Send the sample to the lab for analysis immediately, or
refrigerate and assay within 24 hours.
9-38 157-1278-916, Rev A
March 2004