Isolation and Identification of Environmental Mycobacteria in the Waters of a Hemodialysis Center

Abstract

The use of poorly treated water during hemodialysis may lead to contamination with nontuberculous mycobacteria (NTM). This study aimed to isolate and identify NTM species in the water of a Brazilian hemodialysis center. We collected 210 samples of water from the hydric system of the unit (post-osmosis system, hemodialysis rooms, reuse system, and hemodialysis equipment) and from the municipal supply network; we isolated the NTM by a classic microbiological technique and identified them by the PCR restriction enzyme pattern of the hsp65 gene (PRA). Fifty-one (24.3%) of the collected samples tested positive for NTM; both the municipal supply network (2 samples, 3.2%) and the hydric system of the hemodialysis center (49 samples, 96.1%) contained NTM. We isolated and identified potentially pathogenic bacteria such as Mycobacterium lentiflavum (59.0%) and M. kansasii (5.0%), as well as rarely pathogenic bacteria like M. gordonae (24.0%), M. gastri (8.0%), and M. szulgai (4.0%). The ability of NTM to cause diseases is well documented in the literature. Therefore, the identification of NTM in the water of a Brazilian hemodialysis center calls for more effective water disinfection procedures in this unit.