Article ; Online: Season, weather and predictors of healthcare-associated Gram-negative bloodstream infections: a case-only study.
The Journal of hospital infection
2018 Volume 101, Issue 2, Page(s) 134–141
Abstract: Background: Recent studies reported seasonality in healthcare-associated infections (HCAI). The association of this phenomenon with other risk factors for HCAI is not clear.: Aim: To analyse the interplay of season, weather and usual predictors of ... ...
| Abstract | Background: Recent studies reported seasonality in healthcare-associated infections (HCAI). The association of this phenomenon with other risk factors for HCAI is not clear. Aim: To analyse the interplay of season, weather and usual predictors of healthcare-associated bloodstream infections caused by Gram-negative bacilli (GNB-BSI). Methods: A case-only study was conducted in a teaching hospital in Brazil. The study enrolled 446 subjects with GNB-BSI diagnosed from July 2012 to June 2016. Demographic data, comorbidities, invasive procedures and use of antimicrobials were reviewed in medical charts. The season in which GNB-BSI occurred, and weather parameters on the day of diagnosis were recorded. Factors associated with occurrence of GNB-BSI in different seasons (reference category: winter) and caused by different GNB (reference category: Escherichia coli) were analysed. Uni- and multi-variable models of multi-nomial logistic regression were used for analysis. Findings: GNB-BSI diagnosed in summer was more likely to be caused by Klebsiella spp. [odds ratio (OR) 5.33; 95% confidence interval (CI) 2.04-13.96] or Acinetobacter baumannii (OR 2.69; 95% CI 1.04-6.96), and there was an association between Klebsiella spp. and spring (OR 2.86; 95% CI 1.14-7.18). Average temperature on the day of diagnosis was associated with Klebsiella spp. (OR 1.19; 95% CI 1.07-1.33) and A. baumannii (OR 1.20; 95% CI 1.07-1.34). Conclusion: Warm seasons and daily temperature impact on the aetiology of GNB-BSI, even in models adjusted for usual risk factors. One possible explanation for these findings is that seasonality of healthcare-associated pathogens is intrinsic to micro-organisms, and not associated with comorbidities, procedures or use of antimicrobials. |
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| MeSH term(s) | Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bacteremia/epidemiology ; Brazil/epidemiology ; Cross Infection/epidemiology ; Female ; Gram-Negative Bacterial Infections/epidemiology ; Hospitals, Teaching ; Humans ; Male ; Middle Aged ; Models, Statistical ; Risk Factors ; Seasons ; Weather ; Young Adult |
| Language | English |
| Publishing date | 2018-06-22 |
| Publishing country | England |
| Document type | Journal Article |
| ZDB-ID | 779366-2 |
| ISSN | 1532-2939 ; 0195-6701 |
| ISSN (online) | 1532-2939 |
| ISSN | 0195-6701 |
| DOI | 10.1016/j.jhin.2018.06.015 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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