title: Seasonal variations in healthcare-associated infection in neonates in Canada.
abstract: OBJECTIVE
  To assess the seasonal pattern of healthcare-associated infections (HCAI) among neonates and to describe the trend of HCAI.
  
  
  METHODS
  Secondary analyses of database.
  
  
  METHODS
  The Canadian Neonatal Network database (2003-2009).
  
  
  METHODS
  Neonates with HCAI defined as blood/cerebrospinal fluid positive with pathogenic organism in a symptomatic infant after 2 days of age.
  
  
  METHODS
  The incidence rate for HCAI per 1000 days with a 95% CI, for the 4 warmest months (June-September) was compared with the remaining 8 months, to calculate the incidence rate ratio (IRR).
  
  
  RESULTS
  Of 75 629 total infants, 4305 (5.7%) had HCAI (3367 had 1 and 938 had >1 episodes). Infants who had HCAI were of lower gestation, birth weight and Apgar score; but had higher severity of illness scores and clinical chorioamnionitis. There was a borderline increase in all HCAI (IRR 1.05, 95% CI 1.00 to 1.11) and a significant increase in Gram-negative HCAI (IRR 1.20, 95% CI 1.04 to 1.39) during the summer months. Overall, there was a 20% reduction in HCAI from 4.45/1000 days in January 2003 to 3.54/1000 days in December 2009 (mean difference 0.91/1000 days (95% CI 0.89 to 0.92).
  
  
  CONCLUSIONS
  Gram-negative infections were significantly increased during the summer months of the year compared with the rest of the year among neonates. Overall, there was a significant temporal reduction in HCAI rates over the study period.
authors.affiliation: Department of Paediatrics, Rm 775 A, Mount Sinai Hospital, Toronto, Ontario M5G 1X5, Canada. pshah@mtsinai.on.ca
authors.forename: Prakesh S
authors.initials: PS
authors.lastname: Shah
authors.forename: Woojin
authors.initials: W
authors.lastname: Yoon
authors.forename: Zarin
authors.initials: Z
authors.lastname: Kalapesi
authors.forename: Kate
authors.initials: K
authors.lastname: Bassil
authors.forename: Michael
authors.initials: M
authors.lastname: Dunn
authors.forename: Shoo K
authors.initials: SK
authors.lastname: Lee
mesh_terms: D002170:Canada / Q000453:epidemiology; D002821:Chorioamnionitis / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D012621:Seasons; D012720:Severity of Illness Index