120
Dayanne Conislla Limaylla et al
Fig. 1. Analysis of blood culture contaminated and positive rates for the prestudy period compared with the study period. A. Blood culture contaminated rates comparing monthly for the study period compared with the prestudy period. B. Proportions of blood culture contaminated and positive rates before and after implementing a quality control circle.
Pudong Health Bureau of Shanghai (grant no. PWRI2016-04). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Conflicts of interest. All authors report no conflicts of interest relevant to this article.
References
1. Dargere S, Parienti JJ, Roupie E, et al. Unique blood culture for diagnosis of bloodstream infections in emergency departments: a prospective multicentre study. Clin Microbiol Infect 2014;20:O920–O927.
2. Lamy B, Dargere S, Arendrup MC, Parienti JJ, Tattevin P. How to optimize the use of blood cultures for the diagnosis of bloodstream infections? A state-of-the art. Front Microbiol 2016;7:697.
Surgical site infections and temperature in the operating theater—Challenges for infection control in developing countries
Dayanne Conislla Limaylla MSc, Marina de Oliveira Silva MS, Marcela Cristina Machado Zanqueta RN and
Carlos Magno Castelo Branco Fortaleza MD, PhD São Paulo State University (UNESP), Botucatu Medical School, City of Botucatu, São Paulo State, Brazil
To the Editor—Healthcare-associated infections (HAIs), and surgical site infections (SSIs) in particular, are more frequent in developing countries compared to Europe and the United States.1, 2 Poor staff adherence to infection control guidelines in the operating theater has been blamed,3 but environmental factors may also be involved in high SSI rates.4
Author for correspondence: Carlos Magno Castelo Branco Fortaleza, Departamento
de Doenças Tropicais, Faculdade de Medicina de Botucatu, Distrito de Rubião Júnior, S/ N Botucatu, São Paulo State, Brazil CEP 18618-970. E-mail:
cmfortaleza@uol.com.br Cite this article: Limaylla DC, et al. (2019). Surgical site infections and temperature in
the operating theater—Challenges for infection control in developing countries. Infection Control & Hospital Epidemiology 2019, 40, 120–121. doi: 10.1017/ice.2018.283
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved In a study conducted from 2011 through 2016, we identified
an association of external environmental temperature and the individual risk of SSI in a teaching hospital in inner Brazil.5 That association was especially strong for higher temperatures (ie, above the 75th or 90th percentile of daily temperatures). Since previous studies reported “summer peaks” of SSI in the United States,6 we hypothesized that ecological changes in the patients’ microbiota could account for our findings. This study complements our previous research; this time we
collected temperatures inside the operating theater. It was con- ducted in the teaching hospital of Botucatu Medical School, a 450-bed facility that provides tertiary care for an area comprising 500,000 inhabitants. The hospital is located in a tropical area (22°
3. Hall KK, Lyman JA. Updated review of blood culture contamination. Clin Microbiol Rev 2006;19:788–802.
4. Alahmadi YM, Aldeyab MA, McElnay JC, et al. Clinical and economic impact of contaminated blood cultures within the hospital setting. J Hosp Infect 2011;77:233–236.
5. Zimmerman FS, Assous MV, Yinnon AM, Wiener-Well Y. Reducing blood culture contamination using a departmental report card. J Hosp Infect 2018;99:236–237.
6. Self WH, Speroff T, Grijalva CG, et al. Reducing blood culture contamination in the emergency department: an interrupted time series quality improvement study. Acad Emerg Med 2013;20:89–97.
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