Fungi in dialysis water and dialysate: occurrence, susceptibility to antifungal agents and biofilm production capacity
Journal of water & health; 00 (0), 2021
Ano de publicação: 2021
The aim of this study was to investigate the occurrence of fungi in dialysis water and dialysate, in addition to evaluating the susceptibility to
antifungals and the biofilm production capacity of isolated microorganisms. The samples were collected in three hemodialysis units in Bauru
(Brazil), every 15 days (July 2017–June 2018) at post-reverse osmosis, reuse, and dialysate points. The fungi were isolated by spread plate on
Sabouraud dextrose agar. Filamentous fungi were phenotypically identified and yeasts were subjected to molecular evaluation of the ITS
region. Susceptibility test to antifungals was carried out by the broth microdilution method and biofilm production capacity was evaluated
in microtiter plates using crystal violet staining. Fungi were isolated in 52/216 (24.1%) samples, with an average count of 16.3 (10–40) CFU/
mL. Overall, 61 microorganisms were identified, with 54 (88.5%) filamentous fungi and 7 (11.5%) yeasts. The main genera included were
Penicillium, Cladosporium, Scedosporium, Rhinocladiella, Fusarium, and Emmonsia. Most isolates showed high values of minimum inhibitory
concentration for 5-flucytosine and fluconazole and 35/45 (77.8%) isolates were classified as strong producers of biofilm. In order to increase
the safety of the dialysis process, the adoption of control measures and monitoring of fungi in hemodialysis fluids is suggested.