title: Seasonal Variation in the Incidence of Late-onset Bleb-related Infection After Filtering Surgery in Japan: The Japan Glaucoma Society Survey of Bleb-related Infection Report 3.
abstract: OBJECTIVE
  To investigate seasonal variations in the incidence of late-onset bleb-related infection after filtering surgery in Japan and the relationship between season and other factors.
  
  
  METHODS
  This multicenter, prospective study is part of a 5-year-long Japan Glaucoma Society survey of bleb-related infection. We analyzed 156 cases of first-time infections (106 men, 50 women) encountered over 5 years to determine the seasonal variation using the Roger test and the relationships between season, sex, and age by logistic regression analysis.
  
  
  RESULTS
  We noted significant monthly seasonal variation in the incidence of infection, which was the highest in January and February (23 and 18 infections, respectively; P=0.018) and lowest from August to November (9, 9, 11, and 8 infections, in that order). Multiple logistic regression analysis revealed that infections were most frequent among women in spring (odds ratio, 8.43; P=0.005). Staphylococcus aureus and Streptococcus spp. infections were more frequent in warmer seasons than in winter. Less virulent species, namely, coagulase-negative Staphylococcus spp., Corynebacterium spp., and Enterococcus spp., were frequently detected in winter. Coagulase-negative Staphylococcus spp. and Haemophilus influenzae were more frequent in women and men, respectively.
  
  
  CONCLUSIONS
  The incidence of late-onset bleb-related infection showed significant seasonal variation and sex differences. The climate in Japan may influence the incidence of bleb-related infection. Moreover, besides climate, physical activity level and lifestyle may contribute to the seasonal variation in the incidence and sex differences in the involved bacterial agents of bleb-related infections in Japan.
authors.affiliation: *The Marui Eye Clinic, Minamisouma †Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima ‡Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu §Center for Medical Statistics, Tokyo, Japan.
authors.forename: Hideto
authors.initials: H
authors.lastname: Sagara
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Tetsuju
authors.initials: T
authors.lastname: Sekiryu
authors.forename: Masashi
authors.initials: M
authors.lastname: Ogasawara
authors.forename: Toshiro
authors.initials: T
authors.lastname: Tango
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D018463:Filtering Surgery / Q000706:statistics & numerical data*; D005901:Glaucoma / Q000601:surgery*; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000458:organization & administration; D011446:Prospective Studies; D012307:Risk Factors; D012621:Seasons; D017678:Sex Distribution; D012955:Societies, Medical / Q000706:statistics & numerical data; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents