Efficacy of Biofilm Removal From Hemodialysis Piping

Central dialysate fluid delivery systems (CDDS) are used by dialysis centers in Japan, and although these systems are effective at delivering dialysate, they have a complex piping network with numerous sites where contamination can develop. In Japan, cleaning disinfectants have been clinically evaluated based on endotoxin levels and bacterial counts, but there have been no published studies evaluating the biofilm removal efficacy of these agents at the electron microscope level