Seasonal changes in the incidence of Escherichia coli bloodstream infection: Variation with region and place of onset

S. R. Deeny*, E. van Kleef, S. Bou-Antoun, Russell Hope, Julie Robotham

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)

Abstract

Previous research has shown that Escherichia coli infection rates peak in the summer; however, to date there has been no investigation as to whether this is seen in both hospital and community-onset cases, and how this differs across regions. We investigated and quantified E. coli bloodstream infection (BSI) seasonality. A generalized additive Poisson model was fitted to mandatory E. coli BSI surveillance data reported in England. There was no impact of seasonality in hospital-onset cases; however, for the community-onset cases, there was statistically significant seasonal variation over time nationally. When examined regionally, seasonality was significant in the North of England only. This variation resulted in an absolute increase of 0.06 (95% CI 0.02-0.1) cases above the mean (3.25) in each hospital trust for each week of the peak summer season, and a decrease of (-) 0.07 (95% CI -0.1 to -0.03) in the autumn. We estimate that fewer than one hospital bed-day per week per hospital is lost because of seasonal increases during the summer. Our findings highlight the need to understand the distinct community and hospital dynamics of E. coli BSI, and to explore the regional differences driving the variation in incidence, in order to design and implement effective control measures.

Original languageEnglish
Pages (from-to)924-929
Number of pages6
JournalClinical Microbiology and Infection
Volume21
Issue number10
DOIs
Publication statusPublished - 1 Oct 2015

Bibliographical note

Funding Information:
We wish to thank all NHS hospitals and laboratories who have contributed data to the mandatory surveillance scheme for E. coli bacteraemia. This research has received funding (S. R. Deeny, J. V. Robotham and E. van Kleef) from the European Community's Seventh Framework Programme FP7/2007-2013 under agreement no. 282512 . The research was partially funded by the NIHR Health Protection Research Unit (HPRU) in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, in partnership with PHE (grant number HPRU_2012_10047 ) and partially funded by the UK NIHR HPRU in Modelling Methodology at Imperial College London, in partnership with PHE (grant number HPRU-2012-10080 ).

Keywords

  • England
  • Escherichia coli
  • Hospital
  • Seasonality
  • Surveillance

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