Seasonal and Temperature-Associated Increases in Gram-Negative Bacterial Bloodstream Infections among Hospitalized Patients 英文参考文献.docVIP

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Seasonal and Temperature-Associated Increases in Gram-Negative Bacterial Bloodstream Infections among Hospitalized Patients 英文参考文献.doc

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Seasonal and Temperature-Associated Increases in Gram-Negative Bacterial Bloodstream Infections among Hospitalized Patients 英文参考文献

SeasonalandTemperature-AssociatedIncreasesin Gram-NegativeBacterialBloodstreamInfectionsamong HospitalizedPatients MichaelR.Eber1*¤,MichelleShardell2,MarinL.Schweizer3,RamananLaxminarayan1,4,EliN. Perencevich3,5 1Center for Disease Dynamics, Economics and Policy, Washington, D.C., United States of America, 2University of Maryland School of Medicine, Baltimore, Maryland, UnitedStatesofAmerica,3UniversityofIowaCarverSchoolofMedicine,IowaCity,Iowa,UnitedStatesofAmerica,4PrincetonEnvironmentalInstitute,Princeton,New Jersey,UnitedStatesofAmerica,5IowaCityVAMedicalCenter,IowaCity,Iowa,UnitedStatesofAmerica Abstract Background:Knowledgeofseasonaltrendsinhospital-associatedinfectionincidencemayimprovesurveillanceandhelp guidethedesignandevaluationofinfectionpreventioninterventions.Weestimatedseasonalvariationinthefrequenciesof inpatientbloodstreaminfections(BSIs)causedbycommonbacterialpathogensandexaminedassociationsofmonthlyBSI frequencieswithambientoutdoortemperature,precipitation,andhumiditylevels. Methods:Adatabasecontainingbloodculturesfrom132U.S.hospitalscollectedbetweenJanuary1999andSeptember 2006 was assembled. The database included monthly counts of inpatient blood cultures positive for several clinically importantGram-negativebacteria(Acinetobacterspp,Escherichiacoli,Klebsiellapneumoniae,andPseudomonasaeruginosa) andGram-positivebacteria(EnterococcussppandStaphylococcusaureus).Monthlymeantemperature,totalprecipitation, andmeanrelativehumidityinthepostalZIPcodesofparticipatinghospitalswereobtainedfromnationalmeteorological databases. Results:Atotalof211,697inpatientBSIswerereportedduring9,423hospital-months.Adjustingforlong-termtrends,BSIs causedbyeachGram-negativeorganismexaminedweremorefrequentinsummermonthscomparedwithwintermonths, withincreasesrangingfrom12.2%forE.coli(95%CI9.2–15.4)to51.8%forAcinetobacter(95%CI41.1–63.2).Summerseason wasassociatedwith8.7%fewerEnterococcusBSIs(95%CI11.0–5.8)andnosignificantchangeinS.aureusBSIfrequency relativetowinter.Indepen