Intravenous literature: De Mauri, A., Chiarinotti, D. and De Leo, M. (2012) Report of a transient increase in tunneled catheter infections following dialysis facility
transfer to a prefabricated structure. The Journal of Vascular Access. Dec 11. [Epub ahead of print].
Purpose – Despite the efforts to promote the native artero-venous fistula as dialysis access, the use of tunneled central venous catheters (tCVC) is increasing. Main complications remain infections of the access, and the environment plays an important role in determining them; however, no studies are available that report dialysis provided in prefabricated temporary buildings. The aim of our study was to assess the incidence of tCVC infections in a container building.
Methods – Since May 2009 our Dialysis Center has been located in a container building. The occurrence of local and systemic infections of tCVC when dialysis was provided in the container was compared with the previous two years, when dialysis was provided at the “Home” center. Each year was also divided into semesters to maintain the temporary relationship between the new location and the infections.
Results – tCVCs represented approximately 13% of all vascular accesses. In the first six months in the temporary building, 50% of patients presented infections, compared to 13% to 20% during the other periods (P=0.02). In the first six months in the container the incidence of infections was 1.44 per 1000 catheters-days, higher than in any other semester (P=0.02). More infections requiring systemic antibacterial agents occurred over this period.
Conclusions – Our study demonstrates that, when a dialysis center is moved to a prefabricated temporary building, the likelihood of tCVC infections increases within the initial months and returns back to the previous levels after a period of adaptation.