Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Hygiene and Environmental Medicine, Berlin, Germany; National Reference Center for Surveillance of Nosocomial Infections, Berlin, Germany; Potsdam Institute for Climate Impact Research, Potsdam, Germany.
Dtsch Arztebl Int. 2019 Aug 5;116(31-32):529-536. doi: 10.3238/arztebl.2019.0529.
Surgical site infections (SSI) are among the most common healthcare- associated infections. The aim of our explorative study was to determine how selected climatic factors are associated with SSI rates.
SSI rates were calculated for operative procedures included in the surgi- cal site infection surveillance component (OP-KISS) of the German Nosocomial Infection Surveillance System (Krankenhaus-Infektions-Surveillance-System, KISS) during the years from 2000 to 2016. The surgeries were associated with department-related and patient-related data. Data of the German Meteorological Service (Deutscher Wetterdienst, DWD), including outdoor temperature and rainfall, were used to analyze the association between climatic factors and rates of SSI. Analyses focused on temperature which showed strong correlations with other climatic parameters. A descriptive analysis was performed, using the chi-squared test. Adjusted odds ratios (AORs) were calculated for SSI rates in relation to tem- perature, using a multivariable logistic regression model.
For the altogether 2 004 793 included operative procedures, 32 118 SSIs were documented. Temperatures ≥ 20 °C were associated with a significantly higher occurrence of SSI compared to temperatures <5 °C (AOR: 1.13; 95% confi- dence intervals [1.06; 1.20]). This increase was found for gram-positive pathogens (AOR: 1.13 [1.03; 1.23]) and, even more pronounced, for gram-negative pathogens (AOR: 1.20 [1.07; 1.35]). The association was strongest for superficial SSI caused by gram-negative pathogens (AOR: 1.38 [1.16; 1.64]).
An association between climatic factors and SSI rates was demon- strated. The predicted rise in global temperatures by up to 4 °C by the end of this century compared to preindustrial levels may increase the likelihood of SSI and should be taken into consideration in future preventive strategies.
手术部位感染（SSI）是最常见的医院获得性感染之一。我们探索性研究的目的是确定选定的气候因素与 SSI 发生率的关系。
计算了 2000 年至 2016 年期间德国医院感染监测系统（Krankenhaus-Infektions-Surveillance-System，KISS）手术部位感染监测部分（OP-KISS）纳入的手术操作的 SSI 发生率。这些手术与科室相关和患者相关的数据相关。德国气象局（Deutscher Wetterdienst，DWD）的数据，包括室外温度和降雨量，用于分析气候因素与 SSI 发生率之间的关系。分析重点是与其他气候参数具有很强相关性的温度。使用卡方检验进行描述性分析。使用多变量逻辑回归模型，计算 SSI 发生率与温度相关的调整优势比（AOR）。
共纳入 2004793 例手术操作，记录了 32118 例 SSI。与温度<5°C 相比，温度≥20°C 与 SSI 发生率显著升高相关（AOR：1.13；95%置信区间[1.06；1.20]）。这种增加适用于革兰氏阳性病原体（AOR：1.13[1.03；1.23]），对于革兰氏阴性病原体，增加更为明显（AOR：1.20[1.07；1.35]）。革兰氏阴性病原体引起的浅表 SSI 的相关性最强（AOR：1.38[1.16；1.64]）。
表明气候因素与 SSI 发生率之间存在关联。与工业化前水平相比，本世纪末全球气温预计上升 4°C，这可能会增加 SSI 的可能性，应在未来的预防策略中考虑到这一点。
