Seasonality and weather determinants of healthcare-associated infections in a teaching hospital

• Grant number: 15/06521-8
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: July 01, 2015
• End date: June 30, 2017
• Field of knowledge: Health Sciences - Collective Health - Epidemiology
• Principal Investigator: Carlos Magno Castelo Branco Fortaleza
• Grantee: Marina de Oliveira Silva
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

The technological revolution in healthcare that took place in the 20th century brought along increased threats for patients´ safety. Among those threats, "Healthcare-associated infections" (HAIs) - formerly known as "nosocomial infections" - stand out as a frequent cause of morbidity and mortality in health services. The most relevant syndromes of HAIs are: surgical site infections (SSI), pneumonias, bloodstream infections (BSI) and urinary tract infections (UTI).The epidemiological determinants of HAIs are: severe and debilitating diseases; invasive procedures (surgeries, placement of intravascular or urinary catheters, mechanical ventilation); work processes in health care; and the use of immune-suppressing drugs or antimicrobials. Surprisingly, seasonal variation in the incidence of HAIs caused by some microorganism (notably Gram-negative bacilli) has been reported in recent studies. However, there are no studies addressing the wide impact of weather parameters on the burden of HAIs in hospitals. That information - besides adding new variables in the causal chain of HAIs - could help improving infection control strategies. In this project, our objective is to address the impact of meteorologic parameters on the incidence of the most relevant HAIs in a teaching hospital (450 beds) located in the city of Botucatu, São Paulo State, Brazil (22°53' S, 48°26' W). The study comprises two sub-projects. In the first, we will analyze series of monthly cumulative incidences of surgical site infections (SSIs) from year 2010 through 2014. Analysis will include: (a) fitting Box-Jenkins stochastic models and testing autocorrelation in order to identify seasonal variation; (b) Poisson regression models used to investigate association of monthly weather parameters (temperature, humidity, rainfall) and monthly incidence rates; (c) analysis of the association of immediate weather parameters and the individual risk of acquiring SSIs. The second subproject aims to analyze time series of incidence density rates of device-associated HAIs in intensive care units. The events of interest are ventilator-associated pneumonia, catheter-related bloodstream infections and catheter-associated urinary tract infections. The period analyzed is the same (2010-2014). Analysis will be similar to itens (a) and (b) from the previous subproject. Analysis will be performed using the following statistical packages: SPSS 20 (IBM, Armonk, NY, USA); NCSS 9 (LLC, Kaysville, Utah, USA) e R 3.1.1 (The R Foundation, Viena, Austria).

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

CASTELO BRANCO FORTALEZA, CARLOS MAGNO; FERREIRA FILHO, SEBASTIAO PIRES; SILVA, MARINA DE OLIVEIRA; QUEIROZ, SANDRA MARA; CAVALCANTE, RICARDO DE SOUZA. Sustained reduction of healthcare-associated infections after the introduction of a bundle for prevention of ventilator-associated pneumonia in medical-surgical intensive care units. Brazilian Journal of Infectious Diseases, v. 24, n. 5, p. 373-379, SEP-OCT 2020. (15/06521-8)

CASTELO BRANCO FORTALEZA, CARLOS MAGNO; SILVA, MARINA DE OLIVEIRA; RODRIGUES, FERNANDA SAAD; DA CUNHA, ANTONIO RIBEIRO. Impact of weather on the risk of surgical site infections in a tropical area. AMERICAN JOURNAL OF INFECTION CONTROL, v. 47, n. 1, p. 92-94, JAN 2019. (15/06521-8)