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Respirology. 2017 May;22(4):778-785. doi: 10.1111/resp.12978. Epub 2017 Jan 17.

Seasonality of pathogens causing community-acquired pneumonia.

Author information

1
Department of Pneumology, Hospital Clinic of Barcelona, University of Barcelona (UB), Barcelona, Spain.
2
Biomedical Research Institute "August Pi Sunyer" (IDIBAPS), Biomedical Research Networking Centres on Respiratory Diseases (CIBERES), Barcelona, Spain.
3
Department of Respiratory Medicine and Infectious Diseases, Evangelic Hospital in Herne and Augusta Hospital in Bochum, Bochum, Germany.
4
Department of Microbiology, Hospital Clinic of Barcelona, Barcelona, Spain.
5
Department of Infectious Diseases, Hospital Clinic of Barcelona, Barcelona, Spain.

Abstract

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.

KEYWORDS:

community-acquired pneumonia; microbial aetiology; season; seasonality

PMID:
28093834
DOI:
10.1111/resp.12978
[Indexed for MEDLINE]

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