Ann Clin Microbiol.  2020 Mar;23(1):33-43. 10.5145/ACM.2020.23.1.33.

Season and Temperature Effects on Bloodstream Infection Incidence in a Korean Tertiary Referral Hospital

• Sohn YS
• Byun JH
• Kim YA
• Shin DC
• Lee K

• KMID: 2471857
• DOI: http://doi.org/10.5145/ACM.2020.23.1.33

Abstract

BACKGROUND
The weather has well-documented effects on infectious disease and reports suggest that summer peaks in the incidences of gram-negative bacterial infections among hospitalized patients. We evaluated how season and temperature changes affect bloodstream infection (BSI) incidences of major pathogens to understand BSI trends with an emphasis on acquisition sites.
METHODS
Incidence rates of BSIs by Staphylococcus aureus, Enterococcus spp., Escherichia coli, Klebsiella pneumoniae, Acinetobacter spp., and Pseudomonas aeruginosa were retrospectively analyzed from blood cultures during 2008-2016 at a university hospital in Seoul, Korea according to the acquisition sites. Warm months (June-September) had an average temperature of ≥20℃ and cold months (December-February) had an average temperature of ≤5℃.
RESULTS
We analyzed 18,047 cases, where 43% were with community-onset BSI. E. coli (N = 5,365) was the most common pathogen, followed by Enterococcus spp. (N = 3,980), S. aureus (N = 3,075), K. pneumoniae (N = 3,043), Acinetobacter spp. (N = 1,657), and P. aeruginosa (N = 927). The incidence of hospital-acquired BSI by Enterococcus spp. was weakly correlated with temperature, and the median incidence was higher during cold months. The incidence of community-onset BSI by E. coli was higher in warm months and was weakly correlated with temperature.
CONCLUSION
We found seasonal or temperature-associated variation in some species-associated BSIs. This could be a useful information for enhancing infection control and public health policies by taking season or climate into consideration.

Keyword

Seasonality; Incidence; Climate change; Bloodstream infection

MeSH Terms

Acinetobacter
Climate
Climate Change
Communicable Diseases
Enterococcus
Escherichia coli
Gram-Negative Bacterial Infections
Humans
Incidence*
Infection Control
Klebsiella pneumoniae
Korea
Pneumonia
Pseudomonas aeruginosa
Public Health
Retrospective Studies
Seasons*
Seoul
Staphylococcus aureus
Tertiary Care Centers*
Weather

Figure

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  Fig. 1. Correlation between bloodstream infection (BSI) by gram-positive cocci and average monthly temperature from 2008–2016 based on Pearson's correlation coefficient. (a) Temperature (°C) vs. incidence rate of community-onset BSI by S. aureus (cases per 105 patient days), y = 0.00337x+1.774, r = 0.0565, P = 0.5612. (b) Temperature (°C) vs. incidence rate of hospital-acquired BSI by S. aureus (cases per 106 patient days), y = 0.0588x+29.781, r = 0.0444, P = 0.6484. (c) Temperature (°C) vs. incidence rate of community-onset BSI by Enterococcus spp. (cases per 105 patient days), y = 0.0488x+9.558, r = 0.0952, P = 0.3273. (d) Temperature (°C) vs. incidence rate of hospital-acquired BSI by Enterococcus spp. (cases per 106 patient days), y = −0.495x+59.061, r = −0.3020, P = 0.0015. CA, community-onset; HA, hospital-acquired; Temp., temperature.

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  Fig. 2. Correlation between bloodstream infection (BSI) by gram-negative bacilli and average monthly temperature from 2008–2016 based on Pearson's correlation coefficient. (a) Temperature (°C) vs. incidence rate of community-onset BSI by E. coli (cases per 105 patient days), y = 0.540x+52.754, r = 0.3304, P = 0.0005. (b) Temperature (°C) vs. incidence rate of hospital-acquired BSI by E. coli (cases per 106 patient days), y = 0.128x+23.142, r = 0.1443, P = 0.1363. (c) Temperature (°C) vs. incidence rate of community-onset BSI by K. pneumoniae (cases per 105 patient days), y = 0.193x+22.874, r = 0.1986, P = 0.0394. (d) Temperature (°C) vs. incidence rate of hospital-acquired BSI by K. pneumoniae (cases per 106 patient days), y = 0.124x+20.931, r = 0.1094, P = 0.2596. CO, community-onset; HA, hospital-acquired; Temp., temperature.

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  Fig. 3. Correlation between bloodstream infection (BSI) by glucose non-fermenters and average monthly temperature from 2008–2016. (a) Temperature (°C) vs. incidence rate of community-onset BSI by Acinetobacter spp. (cases per 105 patient days), y = 0.0500x+2.065, r = 0.2100, P = 0.0292. (b) Temperature (°C) vs. incidence rate of hospital-acquired BSI by Acinetobacter spp. (cases per 106 patient days), y = −0.121x+25.202, r = −0.1148, P = 0.2368. (c) Temperature (°C) vs. incidence rate of community-onset BSI by P. aeruginosa (cases per 105 patient days), y = 0.000520x+0.455, r = 0.0137, P = 0.8879. (d) Temperature (°C) vs. incidence rate of hospital-acquired BSI by P. aeruginosa (cases per 106 patient days), y = 0.0565x+8.814, r = −0.0957, P = 0.3241. CO, community-onset; HA, hospital-acquired; Temp., temperature.

Reference

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