Emerging Evidence for Seasonality of Gram-Negative Bacterial Infections

Freeman, Joshua T.; Anderson, Deverick J.; Sexton, Daniel J.

doi:10.1086/597506

Cited by 6 publications

(5 citation statements)

References 11 publications

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“…A more complete understanding of the incidence patterns of acquisition of other pathogens may provide an opportunity for the identification of potential aetiologic factors, as well as refinement of infection control strategies for these infections. Seasonal variation of infectious diseases is often observed [7] and increasing evidence suggests that many Gram-negative infections display such patterns [8, 9]. Previously, we reported differential seasonal acquisition of initial P. aeruginosa in young children with CF and no such variation for MSSA infections [10].…”

Section: Introductionmentioning

confidence: 92%

Seasonality of acquisition of respiratory bacterial pathogens in young children with cystic fibrosis

et al. 2017

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BackgroundSeasonal variations are often observed for respiratory tract infections; however, limited information is available regarding seasonal patterns of acquisition of common cystic fibrosis (CF)-related respiratory pathogens. We previously reported differential seasonal acquisition of Pseudomonas aeruginosa in young children with CF and no such variation for methicillin-susceptible Staphylococcus aureus acquisition. The purpose of this study was to describe and compare the seasonal incidence of acquisition of other respiratory bacterial pathogens in young children with CF.MethodsWe conducted a retrospective study to describe and compare the seasonal incidence of methicillin-resistant Staphylococcus aureus (MRSA), Stenotrophomonas maltophilia, Achromobacter xylosoxidans, and Haemophilus influenzae acquisition in young CF patients residing in the U.S. using the Cystic Fibrosis Foundation National Patient Registry, 2003-2009. Log-linear overdispersed Poisson regression was used to evaluate seasonal acquisition of each of these pathogens.ResultsA total of 4552 children met inclusion criteria. During follow-up 910 (20%), 1161 (26%), 228 (5%), and 2148 (47%) children acquired MRSA, S. maltophilia, A. xylosoxidans and H. influenzae, respectively. Compared to winter season, MRSA was less frequently acquired in spring (Incidence Rate Ratio [IRR]: 0.79; 95% Confidence Interval [CI]: 0.65, 0.96) and summer (IRR: 0.69; 95% CI: 0.57, 0.84) seasons. Similarly, a lower rate of A. xylosoxidans acquisition was observed in spring (IRR: 0.59; 95% CI: 0.39, 0.89). For H. influenzae, summer (IRR: 0.88; 95% CI: 0.78, 0.99) and autumn (IRR: 0.78; 95% CI: 0.69, 0.88) seasons were associated with lower acquisition rates compared to winter. No seasonal variation was observed for S. maltophilia acquisition.ConclusionAcquisition of CF-related respiratory pathogens displays seasonal variation in young children with CF, with the highest rate of acquisition for most pathogens occurring in the winter. Investigation of factors underlying these observed associations may contribute to our understanding of the aetiology of these infections and guide future infection control strategies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2511-9) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 92%

Seasonality of acquisition of respiratory bacterial pathogens in young children with cystic fibrosis

et al. 2017

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“…Recently, summer peaks in the incidence of gram-negative bacterial infection among hospitalized patients have been reported. 4,6,7 It is also known that Acinetobacter infection demonstrates seasonal variation and that infection rates are twice as high in late summer months as in early winter months. 8 In fact, seasonality is often a major factor associated with recurrent epidemics of infectious disease, especially for childhood infectious diseases, such as measles, whooping cough, influenza, and infection with respiratory syncytial virus, rotavirus, and norovirus.…”

Section: Infect Control Hosp Epidemiol 2010; 31(11):1154-1159mentioning

confidence: 99%

Seasonal and Ascending Trends in the Incidence of Carriage of Extended-Spectrumβ-Lactamase–ProducingEscherichia coliandKlebsiellaSpecies in 2 German Hospitals

Kaier

Frank

Conrad

et al. 2010

Infect. Control Hosp. Epidemiol.

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“…Multicenter data on the seasonality of Gram-positive and Gram-negative clinical isolates in ICUs remain scare [11], [12]. Thus, the aim of our study was to look for temperature associations of pathogens in a network of geographically variant intensive care units in Germany and to discuss reasons for and implications of seasonal variation.…”

Section: Introductionmentioning

confidence: 99%

The Warmer the Weather, the More Gram-Negative Bacteria - Impact of Temperature on Clinical Isolates in Intensive Care Units

2014

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BackgroundWe investigated the relationship between average monthly temperature and the most common clinical pathogens causing infections in intensive care patients.MethodsA prospective unit-based study in 73 German intensive care units located in 41 different hospitals and 31 different cities with total 188,949 pathogen isolates (102,377 Gram-positives and 86,572 Gram-negatives) from 2001 to 2012. We estimated the relationship between the number of clinical pathogens per month and the average temperature in the month of isolation and in the month prior to isolation while adjusting for confounders and long-term trends using time series analysis. Adjusted incidence rate ratios for temperature parameters were estimated based on generalized estimating equation models which account for clustering effects.ResultsThe incidence density of Gram-negative pathogens was 15% (IRR 1.15, 95%CI 1.10–1.21) higher at temperatures ≥20°C than at temperatures below 5°C. E. cloacae occurred 43% (IRR = 1.43; 95%CI 1.31–1.56) more frequently at high temperatures, A. baumannii 37% (IRR = 1.37; 95%CI 1.11–1.69), S. maltophilia 32% (IRR = 1.32; 95%CI 1.12–1.57), K. pneumoniae 26% (IRR = 1.26; 95%CI 1.13–1.39), Citrobacter spp. 19% (IRR = 1.19; 95%CI 0.99–1.44) and coagulase-negative staphylococci 13% (IRR = 1.13; 95%CI 1.04–1.22). By contrast, S. pneumoniae 35% (IRR = 0.65; 95%CI 0.50–0.84) less frequently isolated at high temperatures. For each 5°C increase, we observed a 3% (IRR = 1.03; 95%CI 1.02–1.04) increase of Gram-negative pathogens. This increase was highest for A. baumannii with 8% (IRR = 1.08; 95%CI 1.05–1.12) followed by K. pneumoniae, Citrobacter spp. and E. cloacae with 7%.ConclusionClinical pathogens vary by incidence density with temperature. Significant higher incidence densities of Gram-negative pathogens were observed during summer whereas S. pneumoniae peaked in winter. There is increasing evidence that different seasonality due to physiologic changes underlies host susceptibility to different bacterial pathogens. Even if the underlying mechanisms are not yet clear, the temperature-dependent seasonality of pathogens has implications for infection control and study design.

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Emerging Evidence for Seasonality of Gram-Negative Bacterial Infections

Cited by 6 publications

References 11 publications

Seasonality of acquisition of respiratory bacterial pathogens in young children with cystic fibrosis

Seasonality of acquisition of respiratory bacterial pathogens in young children with cystic fibrosis

Seasonal and Ascending Trends in the Incidence of Carriage of Extended-Spectrumβ-Lactamase–ProducingEscherichia coliandKlebsiellaSpecies in 2 German Hospitals

The Warmer the Weather, the More Gram-Negative Bacteria - Impact of Temperature on Clinical Isolates in Intensive Care Units

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