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Seasonal Variation of Escherichia coli, Staphylococcus aureus, and Streptococcuspneumoniae Bacteremia According to Acquisition and Patient Characteristics: A Population-Based Study

Published online by Cambridge University Press:  04 May 2016

Kim Oren Gradel ,
Stig Lønberg Nielsen ,
Court Pedersen ,
Jenny Dahl Knudsen ,
Christian Østergaard ,
Magnus Arpi ,
Thøger Gorm Jensen ,
Hans Jørn Kolmos ,
Mette Søgaard  and
Annmarie Touborg Lassen
...Show all authors
Kim Oren Gradel*
Affiliation:
Center for Clinical Epidemiology, South, Odense University Hospital, and Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
Stig Lønberg Nielsen
Affiliation:
Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
Court Pedersen
Affiliation:
Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
Jenny Dahl Knudsen
Affiliation:
Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre Hospital, Hvidovre, Denmark
Christian Østergaard
Affiliation:
Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre Hospital, Hvidovre, Denmark
Magnus Arpi
Affiliation:
Department of Clinical Microbiology, Copenhagen University Hospital, Herlev Hospital, Herlev, Denmark
Thøger Gorm Jensen
Affiliation:
Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
Hans Jørn Kolmos
Affiliation:
Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
Mette Søgaard
Affiliation:
Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
Annmarie Touborg Lassen
Affiliation:
Department of Emergency Medicine, Odense University Hospital, Odense, Denmark
Henrik Carl Schønheyder
Affiliation:
Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark Department of Clinical Medicine, Aalborg University, AalborgDenmark
*
Address correspondence to Kim Oren Gradel, DVM, PhD, Center for Clinical Epidemiology, OUH Odense University Hospital, Sdr. Boulevard 29, Entrance 101, 4th floor, DK-5000 Odense C, Denmark ([email protected]).
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Abstract

OBJECTIVE

Seasonal variation is a characteristic of many infectious diseases, but relatively little is known about determinants thereof. We studied the impact of place of acquisition and patient characteristics on seasonal variation of bacteremia caused by the 3 most common pathogens.

DESIGN

Seasonal variation analysis.

METHODS

In 3 Danish health regions (2.3 million total inhabitants), patients with bacteremia were identified from 2000 through 2011 using information from laboratory information systems. Analyses were confined to Escherichia coli, Staphylococcus aureus, and Streptococcus pneumoniae. Additional data were obtained from the Danish National Hospital Registry for the construction of admission histories and calculation of the Charlson comorbidity index (CCI). Bacteremias were categorized as community acquired, healthcare associated (HCA), and hospital acquired. We defined multiple subgroups by combining the following characteristics: species, acquisition, age group, gender, CCI level, and location of infection. Assuming a sinusoidal model, seasonal variation was assessed by the peak-to-trough (PTT) ratio with a 95% confidence interval (CI).

RESULTS

In total, we included 16,006 E. coli, 6,924 S. aureus, and 4,884 S. pneumoniae bacteremia cases. For E. coli, the seasonal variation was highest for community-acquired cases (PTT ratio, 1.24; 95% CI, 1.17–1.32), was diminished for HCA (PTT ratio, 1.14; 95% CI, 1.04–1.25), and was missing for hospital-acquired cases. No seasonal variation was observed for S. aureus. S. pneumoniae showed high seasonal variation, which did not differ according to acquisition (overall PTT ratio, 3.42; 95% CI, 3.10–3.83).

CONCLUSIONS

Seasonal variation was mainly related to the species although the place of acquisition was important for E. coli.

Infect Control Hosp Epidemiol 2016;37:946–953

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 8 , August 2016 , pp. 946 - 953
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

PREVIOUS PRESENTATION. Gradel KO, Nielsen SL, Pedersen C, Knudsen JD, Østergaard C, Arpi M, Jensen TG, Kolmos HJ, Søgaard M, Lassen AT presented these data in part as Poster P0012, “Seasonal variation in blood stream infection in relation to bacterial agents and acquisition” at the 25th European Congress of Clinical Microbiology and Infectious Diseases, April 25–28, 2015, in Copenhagen, Denmark.

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