국내 3차병원의 혈류감염 발생률에 계절 및 온도가 미치는 영향

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.