Higher incidence of catheter-related infections in a tropical climate.

Catheter-related infections (CRIs) have become a prominent morbidity factor in continuous ambulatory peritoneal dialysis (CAPD). To confirm a clinical impression that CRI rates in our population (n = 80, 1080 patient-months) were unusually high, a retrospective study was performed. In addition, data from adult patients treated for at least 12 months were analyzed (n = 28, 325 patient-months) to determine if climate conditions could account for our findings. Comparisons were made between CRI rates during months with a mean maximal temperature of 32 degrees C or higher (hot season) and CRI rates during months with a mean temperature lower than 28 degrees C (control season). Two-cuff Tenckhoff catheters were used on 68 occasions and the Swan neck Missouri catheter 2 on 20 occasions. Main CAPD systems were the O-set (n = 48) and the disposable Y-set (n = 35). A total of 139 CRI episodes were recorded with a rate of 1/8 patient-months. A CRI was implicated as a causative factor in 18 of 69 episodes of peritonitis (26%) and in 13 of 27 catheter losses (48%). CRI rates were similar when comparing either Swan neck versus Tenckhoff catheters (1/7 and 1/8 patient-months) or the O-set versus disposable Y-set (1/7 and 1/10 patient-months). Most importantly, a significantly higher incidence of CRI was found during the hot seasons in comparison to the control seasons (1/9 vs 1/19 patient-months, p < 0.05, one-way signed rank test). Our data suggest that a hot climate can adversely affect the rate of CRIs.