Abstract
BackgroundSeasonal variation has been observed for various bacterial and viral infections. We aimed to further study seasonality of respiratory viruses and bacterial pathogens in relation to antibiotic use, as well as meteorological parameters.MethodsAn ecologic study of antibiotic exposure, meteorological parameters, detection of respiratory viruses and clinical isolates of Clostridioides difficile, Methicillin-resistant Staphylococcus aureus (MRSA), Streptococcus pneumoniae, and Escherichia coli and Klebsiella pneumoniae (grouped together as gram-negative bacteria; GNB) in Rhode Island from 2012 to 2016.ResultsPeak detection of C. difficile occurred 3 months after the peak in antibiotic prescriptions filled (OR = 1.24, 95% CI, 1.07–1.43; P = 0.006). Peak MRSA detection was noted 7 months after the peak in antibiotic prescriptions filled (OR = 1.69, 95% CI, 1.21–2.35; P = 0.003) and 10 months after the peak in respiratory virus detection (OR = 1.04, 95% CI, 1.01–1.06; P = 0.003). Peak GNB detection was noted 2 months after the peak mean monthly ambient temperature (OR = 1.69, 95% C.I., 1.20–2.39; P = 0.004). Peak detection of S. pneumoniae was noted at the same time as the peak in detection of respiratory viruses (OR = 1.01, 95% C.I., 1.00–1.01; P = 0.015).ConclusionsWe identified distinct seasonal variation in detection of respiratory viruses and bacterial pathogens. C. difficile seasonality may, in part, be related to antibiotic prescriptions filled; GNB seasonality may be related to ambient temperature and S. pneumoniae may be related to concurrent respiratory viral infections.
Highlights
Seasonal variation has been observed for various bacterial and viral infections
Many host-related risk factors have been established for bacterial infections; non-intrinsic factors such as respiratory viral infections, weather conditions, and latitude are among other factors that lead to seasonality of such infections [1,2,3,4,5,6]
Clostridioides difficile toxin was identified by PCR testing of stool specimens (BD GeneOhm; Xpert); growth in clinical cultures identified cases involving Methicillin-resistant Staphylococcus aureus (MRSA), Streptococcus pneumoniae, and Escherichia coli and Klebsiella pneumoniae
Summary
Seasonal variation has been observed for various bacterial and viral infections. We aimed to further study seasonality of respiratory viruses and bacterial pathogens in relation to antibiotic use, as well as meteorological parameters. Many host-related risk factors have been established for bacterial infections; non-intrinsic factors such as respiratory viral infections, weather conditions, and latitude are among other factors that lead to seasonality of such infections [1,2,3,4,5,6]. Clostridioides difficile infection is temporally associated with respiratory tract infections [6,7,8], likely due to antibiotic overprescribing for respiratory viral infections. A better understanding of seasonality of various pathogens, as well as an association with antibiotic prescriptions may allow us to devise and implement future
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