Original ArtIcle

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

Young Suk  Sohn1   Jung-Hyun  Byun2   Young Ah  Kim3 *   Dong Chun  Shin4   Kyungwon  Lee1   

1Department of Laboratory Medicine, Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul
2Department of Laboratory Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju
3Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang
4Department of Environmental Health Graduate School of Public Health, Yonsei University, Seoul, Korea

Abstract

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.

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 °C and cold months (December–February) had an average temperature of ≤5 °C.

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.

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.

Figures & Tables

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.