Summer, sun and sepsis—The influence of outside temperature on nosocomial bloodstream infections: A cohort study and review of the literature

Schwab, Frank J.; Gastmeier, Petra; Hoffmann, Peter; Meyer, Elisabeth

doi:10.1371/journal.pone.0234656

Cited by 30 publications

(22 citation statements)

References 35 publications

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“…Authors reported a significant increase in the likelihood of hospitalacquired bloodstream infections caused by gram-negative bacteria (particularly Acinetobacter spp and Enterobacter spp) in months with higher mean temperatures. 30 The similarity of our results to the findings of Schwab et al indicates that meteorological factors impact the occurrence and causing pathogens of not only SSIs but also other healthcare-associated infections. Overall, explanations for the observed results and shifts in pathogen distribution attributable to temperature remain speculative to a certain extent due to the novelty of this type of research and the lack of data on interactions of the human microbiome and infection vulnerability.…”

Section: Discussionsupporting

confidence: 89%

Increase in surgical site infections caused by gram-negative bacteria in warmer temperatures: Results from a retrospective observational study

Aghdassi

Gastmeier

Hoffmann

et al. 2020

Infect. Control Hosp. Epidemiol.

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Objective: Surgical site infections (SSIs) occur more frequently during periods of warmer temperatures. We aimed to investigate for which pathogens this association is particularly strong. Design: A retrospective observational study was conducted. Methods: Data from the SSI-module of the German nosocomial infection surveillance system between 2000 and 2016 were linked with data from the German Meteorological Service. Patient- and procedure-related data were associated with monthly aggregated meteorological data. Due to high correlation with other meteorological parameters, we focused on the outside temperature. Adjusted odds ratios were calculated for SSI rates relating to temperature. SSIs were stratified by pathogen. A P value of <.05 was considered significant. Results: Altogether, 2,004,793 procedures resulting in 32,118 SSIs were included. Generally, warmer temperatures were associated with a higher SSI risk, especially for SSIs with gram-negative pathogens. This association was particularly prominent for Acinetobacter spp, Pseudomonas aeruginosa, and certain Enterobacteriaceae. Per additional 1°C, we observed a 6% increase in the SSI risk for Acinetobacter spp and a 4% increase for Enterobacter spp. Superficial SSIs with Acinetobacter spp were 10 times more likely to occur when comparing surgeries in months with mean temperatures of ≥20°C to mean temperatures of <5°C. Conclusions: Higher temperatures were associated with increased SSI rates caused by gram-negative bacteria. Future SSI prevention measures should consider this aspect. Underlying shifts in microbiome composition due to climate factors should be included in further analyses. Given the expected rise of global temperatures until the end of the century, this topic has relevance from multiple perspectives.

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Section: Discussionsupporting

confidence: 89%

Increase in surgical site infections caused by gram-negative bacteria in warmer temperatures: Results from a retrospective observational study

Aghdassi

Gastmeier

Hoffmann

et al. 2020

Infect. Control Hosp. Epidemiol.

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“…Air temperature and relative humidity have been reported to correlate with indoor microbial community richness in different buildings and environments [ 1 , 16 , 63 , 64 ]. Moreover, in the clinical setting, a number of studies have already reported seasonal and temperature-associated increases of bacterial bloodstream infections [ 65 , 66 ] and surgical site infections [ 67 ] in hospitalized patients. In our study, air temperature and relative humidity were recorded in all rooms at the time of sampling.…”

Section: Discussionmentioning

confidence: 99%

Bacterial colonization dynamics and antibiotic resistance gene dissemination in the hospital environment after first patient occupancy: a longitudinal metagenetic study

et al. 2021

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Background Humans spend the bulk of their time in indoor environments. This space is shared with an indoor ecosystem of microorganisms, which are in continuous exchange with the human inhabitants. In the particular case of hospitals, the environmental microorganisms may influence patient recovery and outcome. An understanding of the bacterial community structure in the hospital environment is pivotal for the prevention of hospital-acquired infections and the dissemination of antibiotic resistance genes. In this study, we performed a longitudinal metagenetic approach in a newly opened ward at the Charité Hospital (Berlin) to characterize the dynamics of the bacterial colonization process in the hospital environment after first patient occupancy. Results The sequencing data showed a site-specific taxonomic succession, which led to stable community structures after only a few weeks. This data was further supported by network analysis and beta-diversity metrics. Furthermore, the fast colonization process was characterized by a significant increase of the bacterial biomass and its alpha-diversity. The compositional dynamics could be linked to the exchange with the patient microbiota. Over a time course of 30 weeks, we did not detect a rise of pathogenic bacteria in the hospital environment, but a significant increase of antibiotic resistance determinants on the hospital floor. Conclusions The results presented in this study provide new insights into different aspects of the environmental microbiome in the clinical setting, and will help to adopt infection control strategies in hospitals and health care-related buildings.

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“…Further, the rate of patients with IDU-IE were lower during the winter compared to the other seasons, which according to our knowledge, has not been presented before. Seasonal changes in infectious diseases have been described before [ 20 ]. Most bacteria tend to increase with rising temperature [ 20 ], which could possibly explain the lower rate of IE during the winter season.…”

Section: Discussionmentioning

confidence: 99%

“…Seasonal changes in infectious diseases have been described before [ 20 ]. Most bacteria tend to increase with rising temperature [ 20 ], which could possibly explain the lower rate of IE during the winter season. The decrease in incidence of IDU-IE after 2011 might be explained by a syringe exchange programme that was introduced in Stockholm at that time.…”

Section: Discussionmentioning

confidence: 99%

Patients with infective endocarditis and history of injection drug use in a Swedish referral hospital during 10 years

Damlin

Westling

2021

BMC Infect Dis

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Background Patients with injection drug use (IDU) have increased risk of developing infective endocarditis (IE). Previous studies have reported recurrent IE, increased duration of hospital stay, poor adherence and compliance as well as higher mortality and worse outcomes after surgery in the IDU-IE patient group. Further studies are needed to provide a basis for optimized care and prevention of readmissions in this population. This study aims to describe the clinical characteristics and outcomes among patients with IDU-IE. Methods Data of adults with IDU-IE and non-IDU-IE, treated between 2008 and 2017 at the Karolinska University Hospital in Stockholm were obtained from the Swedish National Registry of Infective Endocarditis. Clinical characteristics, microbiological results, treatment durations, results from echocardiography and in-hospital mortality were compared between the groups. Results Of the total 522 patients, 165 (32%) had IDU-IE. Patients with IDU-IE were younger than the patients with non-IDU-IE (mean age IDU-IE: 41.6 years, SD 11.9 years; non-IDU-IE: 64.3 years, SD 16.4 years; P < 0.01). No difference in distribution of gender was observed, 33% were females in both the IDU-IE and the non-IDU-IE group. History of previous IE (IDU-IE: n = 49, 30%; non-IDU-IE: n = 34, 10%; P < 0.01) and vascular phenomena (IDU-IE: n = 101, 61%; non-IDU-IE: n = 120, 34%; P < 0.01) were more common among patients with IDU-IE while prosthetic heart valves (IDU-IE: n = 12, 7%; non-IDU-IE: n = 83, 23%; P < 0.01) and known valvular disease (IDU-IE: n = 3, 2%; non-IDU-IE: n = 78, 22%; P < 0.01) were more common among patients with non-IDU-IE. Aetiology of Staphylococcus aureus (IDU-IE: n = 123, 75%; non-IDU-IE: n = 118, 33%; P < 0.01) as well as tricuspid (IDU-IE: n = 91, 55%; non-IDU-IE: n = 23, 6%; P < 0.01) or pulmonary valve vegetations (IDU-IE: n = 7, 4%; non-IDU-IE: n = 2, 1%; P < 0.01) were more common in the IDU-IE group. The overall incidence of IDU-IE decreased during the study period, while the incidence of definite IE increased (P < 0.01). Conclusions This study presents that patients with IDU-IE were younger, less frequently treated with surgery and had higher prevalence of vascular phenomena and history of previous IE, aspects that are important for improved management of this population.

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Summer, sun and sepsis—The influence of outside temperature on nosocomial bloodstream infections: A cohort study and review of the literature

Cited by 30 publications

References 35 publications

Increase in surgical site infections caused by gram-negative bacteria in warmer temperatures: Results from a retrospective observational study

Increase in surgical site infections caused by gram-negative bacteria in warmer temperatures: Results from a retrospective observational study

Bacterial colonization dynamics and antibiotic resistance gene dissemination in the hospital environment after first patient occupancy: a longitudinal metagenetic study

Patients with infective endocarditis and history of injection drug use in a Swedish referral hospital during 10 years

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