title: Report of a transient increase in tunneled catheter infections following dialysis facility transfer to a prefabricated structure.
abstract: OBJECTIVE
  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.
authors.affiliation: Nephrology and Dialysis Unit, Maggiore della Carità Hospital, Novara, Italy. andreanademauri@libero.it
authors.forename: Andreana
authors.initials: A
authors.lastname: De Mauri
authors.forename: Doriana
authors.initials: D
authors.lastname: Chiarinotti
authors.forename: Martino
authors.initials: M
authors.lastname: De Leo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D055499:Catheter-Related Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D062905:Central Venous Catheters / Q000009:adverse effects*; D016009:Chi-Square Distribution; D005160:Facility Design and Construction; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents