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Artigo Produção Nacional Revisado por pares
BIBTEX RIS

Season, weather and predictors of healthcare-associated Gram-negative bloodstream infections: a case-only study

2018; Elsevier BV; Volume: 101; Issue: 2 Linguagem: Inglês

10.1016/j.jhin.2018.06.015

ISSN

1532-2939

Autores

Fernanda Saad Rodrigues, Fernanda Avelina Clemente de Luca, Antônio Ribeiro da Cunha, Carlos Magno Castelo Branco Fortaleza,

Tópico(s)

Patient Satisfaction in Healthcare

Resumo

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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