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Seasonality of pathogens causing community‐acquired pneumonia
Author(s) -
Cilloniz Catia,
Ewig Santiago,
Gabarrus Albert,
Ferrer Miquel,
Puig de la Bella Casa Jorge,
Mensa Josep,
Torres Antoni
Publication year - 2017
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12978
Subject(s) - streptococcus pneumoniae , medicine , community acquired pneumonia , etiology , pneumonia , legionella pneumophila , seasonality , incidence (geometry) , veterinary medicine , microbiology and biotechnology , antibiotics , biology , bacteria , ecology , genetics , physics , optics
Background and objective Seasonal distribution of microbial aetiology in patients with community‐acquired pneumonia ( CAP ) may add important information both for epidemiologists and clinicians. We investigate the seasonal distribution of microbial aetiology in CAP . Methods This prospective observational study was carried out in the Hospital Clinic of Barcelona, Spain (January 2003–December 2014). Results We studied 4431 patients with CAP , of whom 2689 (61%) were males. Microbial aetiology was identified in 1756 patients (40%). CAP was most frequent in winter (34%) but two‐third of patients with CAP presented in other seasons. Seasonal variations included Streptococcus pneumoniae (winter 21% vs spring 17% vs summer 14% vs autumn 13%, overall P < 0.001). Influenza viruses were most prevalent in autumn (6%) and winter (5%) compared with spring (3%) and summer (1%) (overall P < 0.001). Legionella pneumophila was most frequent in autumn (4%) and summer (4%) compared with spring (2%) and winter (1%) (overall P < 0.001). Incidence of polymicrobial pneumonia also differed between seasons (winter 7% vs spring 5% vs summer 3% vs autumn 6%, overall P = 0.001). We observed a significant correlation between the lowest seasonal average temperature and polymicrobial pneumonia, pneumococcal pneumonia, and influenza viruses; conversely, L. pneumophila was more common when temperatures were higher. Conclusion CAP should not be regarded as a seasonal disease but occurs throughout all seasons. However, S. pneumoniae , influenza viruses, polymicrobial pneumonia and L. pneumophila are clearly subject to seasonal variations.