Spatio-Temporal Trend Analysis of Sepsis Cases in the State of São Paulo, Brazil, between 2013 and 2022

• Grant number: 24/19967-3
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: January 01, 2025
• End date: December 31, 2025
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Carlos Roberto Veiga Kiffer
• Grantee: Mateus Menezes dos Santos
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil

Abstract

This project aims to continue the spatio-temporal analysis of sepsis cases in the state of São Paulo between 2013 and 2022, as part of a postdoctoral research project entitled "**Estimation of the burden related to the occurrence and spread of bacterial resistance to antimicrobials in bloodstream infection cases from the perspective of the unified health system**", by postdoctoral researcher Dr. Érico Vinícius de Souza Carmo. This line of research is associated with CEPID ARIES (Antimicrobial Resistance Institute of São Paulo) and the Infectious Diseases Department of the Paulista School of Medicine - UNIFESP, although currently without funding or support from any research funding institution.The analysis of sepsis trends in the state of São Paulo is crucial for this research, as it provides important insights into patterns of this infectious syndrome and will allow inferences about associated antimicrobial resistance over time. By understanding the distribution patterns and evolution of sepsis in the state, we can generate future inferences about trends in various associated antimicrobial resistances, a critical factor in understanding this condition and the consequent control and treatment strategies. Furthermore, this project will assist in analyzing and identifying geographic areas and populations at higher risk, allowing for more accurate estimates of the burden of sepsis on populations in the state.During the initial process of conducting this research, a significantly heterogeneous distribution of lethality and hospitalization with sepsis was found, as well as a significant increase in the rate of hospitalization with sepsis over the years in the State of São Paulo. However, it was observed that lethality remained constant over time.These observations point to the need for a more in-depth analysis of the causes of geographical and temporal distribution discrepancies, which may be related to factors such as the age range of hospitalized patients, human development indicators, and availability of hospital beds in municipalities. The analysis by age group will allow us to observe whether the distribution of cases across the state is directly related to subpopulations of different ages, such as children, adults, and the elderly, as well as detect if there are differences within each demographic group. By identifying and analyzing these possible disparities, we can detect potential differences in the occurrence and clinical evolution of sepsis among various groups. Similarly, the development indicators of the municipality where hospitalization occurs, especially the Human Development Index (HDI), may impact the hospitalization and lethality patterns found. Therefore, the relationship between municipal HDI and the distribution and evolution of sepsis cases over time will be addressed. It will be possible to investigate whether HDI is related to hospitalization rates as well as sepsis lethality in the state of São Paulo. Another relationship that will be examined is with the number of inpatient and ICU beds available in municipalities, seeking to understand if there is a relationship between hospitalization infrastructure and the distribution of hospitalizations and lethality with sepsis in the state. Thus, it is of great importance that the research continues so that new results corroborate the data already obtained.