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. 2021 Aug 19;16(8):e0255593.
doi: 10.1371/journal.pone.0255593. eCollection 2021.

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

Sebastião Pires Ferreira Filho  1 , Milca Severino Pereira  2 , Jorge Luiz Nobre Rodrigues  3 , Raul Borges Guimarães  4 , Antônio Ribeiro da Cunha  5 , José Eduardo Corrente  6 , Antônio Carlos Campos Pignatari  7 , Carlos Magno Castelo Branco Fortaleza  1
Affiliations

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

Sebastião Pires Ferreira Filho et al. PLoS One. .

Abstract

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.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Map of Brazil, showing the cities that host the study hospitals.
Note. This figure copyrights belong to the authors. Figure was drawn in ArCGis 10 (ESRI, Redlands, CA).
Fig 2
Fig 2. Monthly incidence of Acinetobacter baumannii bloodstream infections in three hospitals from different places in Brazil.
Note. ICU, intensive care units; Wards, units for non-critically ill patients; Carb-R, carbapenem-resistant; CARB-S, carbapenem-susceptible.
See this image and copyright information in PMC

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