Seasonality and weather dependance of Acinetobacter baumannii complex bloodstream infections in different climates in Brazil

• Published in: PloS one 2021-08, Vol.16 (8), p.e0255593
• Main Authors: Filho, Sebastião Pires Ferreira, Pereira, Milca Severino, Nobre Rodrigues, Jorge Luiz, Guimarães, Raul Borges, Ribeiro da Cunha, Antônio, Corrente, José Eduardo, Campos Pignatari, Antônio Carlos, Fortaleza, Carlos Magno Castelo Branco
• Format: Article
• Language: English
• Subjects: Acinetobacter baumannii; Acinetobacter infections; Biology and Life Sciences; Cities; Climate; Climate control; Climate models; Confidence intervals; Dengue fever; Distribution; Earth Sciences; Ecological effects; Environmental aspects; Health aspects; Health care; Hospitals; Humidity; Impact analysis; Infections; Infectious diseases; Influence; Intensive care; Intensive care units; Medicine; Medicine and Health Sciences; Parameters; People and places; Rain; Regression analysis; Regression models; Risk factors; Seasonal variations; Seasons; Social Sciences; Software; Statistical analysis; Temperature control; Time series; Trends; Tropical diseases; Weather
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0255593

Recent studies report seasonality in healthcare-associated infections, especially those caused by Acinetobacter baumannii complex. We conducted an ecologic study aimed at analyzing the impact of seasons, weather parameters and climate control on the incidence and carbapenem-resistance in A. baumannii complex bloodstream infections (ABBSI) in hospitals from regions with different climates in Brazil. We studied monthly incidence rates (years 2006-2015) of ABBSI from hospitals in cities from different macro-regions in Brazil: Fortaleza (Ceará State, Northeast region), Goiânia (Goiás State, Middle-west) and Botucatu (São Paulo State, Southeast). Box-Jenkins models were fitted to assess seasonality, and the impact of weather parameters was analyzed in Poisson Regression models. Separate analyses were performed for carbapenem-resistant versus carbapenem-susceptible isolates, as well as for infections occurring in climate-controlled intensive care units (ICUs) versus non-climate-controlled wards. Seasonality was identified for ABSSI ICUs in the Hospitals from Botucatu and Goiânia. In the Botucatu hospital, where there was overall seasonality for both resistance groups, as well as for wards without climate control. In that hospital, the overall incidence was associated with higher temperature (incidence rate ratio for each Celsius degree, 1.05; 95% Confidence Interval, 1.01-1.09; P = 0.006). Weather parameters were not associated with ABBSI in the hospitals from Goiânia and Fortaleza. In conclusion, seasonality was found in the hospitals with higher ABBSI incidence and located in regions with greater thermal amplitude. Strict temperature control may be a tool for prevention of A. baumanii infections in healthcare settings.