Should dialysis machines be disinfected between patients' shifts?

The disinfection of dialysis machines is performed after each session in some units but only at the end of the day in other ones. In a multicentre study, in 15 units (five with and ten without disinfection after each session), the incidence of sero-conversion for HCV was reduced to zero, after reinforcement of general hygiene precautions only, without changing the above-mentioned machine disinfection policies. Recently reported episodes of blood contamination of dialysis machines beyond pressure transducers demonstrate that pressure isolator inspection and care should be added to the general hygiene precautions. In a second investigation, no difference was found in dialysate bacterial and endotoxin characteristics between dialysis machines, disinfected after each dialysis (n = 2) and those disinfected at the end of the day only (n = 2). In conclusion, the systematic disinfection of all dialysis machines after each session does not appear to help prevent HCV infection nor to have a detectable impact on optimal dialysate bacterial and endotoxin characteristics.