Clinical study on the distribution of acute respiratory pathogens after the unsealing of COVID-19

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Methods Data of multiple RT-PCR and capillary electrophoresis fragment analysis were collected from hospitalized children aged 0-6 years who were diagnosed and treated for acute respiratory tract infection in Qingyuan People's Hospital from December 2022 to December 2023, and the results were statistically analyzed by SPSS 17.0. Results The total positive rate of acute respiratory pathogen infection was 65.49% (2306/3521), and the highest positive rate was HRV (21.81%), followed by HRSV (14.23%, 501/3521) and InfA (8.26%, 291/3521). The positive rate of at least one pathogen in male children was 73.77% (1 640/2223), as in female children was 72.88% (946/1298). The positive rate of respiratory pathogens in preschool children group was 71.47%(987/1381),which was higher than in the early childhood group (694/985,70.46%) and in the babyhood group(625/1155,54.11%), and the difference was statistically significant( c 2 =98.760， P< 0.001).The positive rate of respiratory pathogens was highest in April(80.71%,251/311),then were in December 2023 (78.66%,199/253) and in November(76.92%,210/273), and the difference was statistically significant( c 2 =423.944， P< 0.05). Conclusion The main pathogens of acute respiratory tract infection in our hospital are HRV, HRSV and InfA. The positive rate of males is higher than that of females, and the positive rate of preschool children is higher. There is a high incidence of infection during the winter and spring changes. Acute respiratory tract infection Epidemiology Multiplex-PCR Influenza virus Respiratory syncytial virus Figures Figure 1 1. Introduction Acute respiratory infections (ARI) are infectious diseases caused by one or more microorganisms such as viruses, bacteria, mycoplasma and chlamydia that invade the respiratory tract. They include the common cold, otitis media, acute bronchiolitis, pharyngitis and pneumonia. It is one of the leading causes of morbidity and mortality worldwide, especially among children [ 1 ] . Common pathogens causing ARI include viruses, bacteria and fungi, among which viruses are more common. Respiratory syncytial virus, parainfluenza virus, influenza virus and adenovirus are the main respiratory viruses infected by children [ 2 ] . There are strict diagnostic criteria for the diagnosis of ARI, but empiric treatment is still common. The clinical symptoms of respiratory infections are often similar, and it is difficult to distinguish viral infections from bacterial infections based on symptoms [ 3 ] . Therefore, a better understanding of the epidemiological and clinical characteristics that lead to ARI is critical to the successful implementation of prevention, control and treatment strategies. The COVID-19 pandemic is having a huge impact on global health. To reduce the previously unknown transmission of SARS-CoV-2, preventive measures such as containment, keeping a safe distance, using masks and raising awareness of hand hygiene have been widely adopted [ 4 ] . These non-pharmaceutical interventions (NPI), also known as public health measures or community mitigation strategies, are thought to be effective against the spread of other respiratory infections as well [ 5 ] . Within two weeks of the declaration of the COVID-19 epidemic in the United States in March 2020, influenza incidence in the United States suddenly declined [ 6 ] . Subsequently, global surveillance studies also confirmed a significant reduction in the occurrence of influenza [ 5 – 8 ] . Several retrospective studies have reported similar findings for other respiratory pathogens, such as syncytial virus, parainfluenza virus, and metapneumovirus [ 8 – 11 ] . However, after the cancellation of NPI, respiratory syncytial virus surged in the summer, while parainfluenza virus and coronavirus are returning to pre-COVID-19 pandemic levels [ 12 ] . At present, traditional immunological techniques are still the main detection techniques for respiratory pathogens in clinical practice, but its methodology has shortcomings such as low positive detection rate, the possibility of false positives, and the inability to distinguish between existing infections and past infections, thus affecting subsequent treatment. The multiple RT-PCR-capillary electrophoresis fragment analysis technology has the advantages of simultaneous detection of 13 kinds of respiratory pathogen nucleic acids through 1 specimen 1 time, triple quality control exclusion of specimens and false negatives caused by experimental process, and the use of UDG enzyme to prevent false positives caused by sample contamination, therefore, the positive detection rate of acute respiratory infection pathogens is high, 13 pathogens can be detected simultaneously ,including Influenza A virus (InfA, including subtypes 2009H1N1 and H3), Influenza B virus (InfB), Human respiratory syncytial virus (HRSV), Human parainfluenza virus (Human parainfluenza virus) HPIV, Human Metapneumovirus (HMPV), Human adenovirus (HADV), Human rhinovirus (HRV), Boca virus (Bocaparvovirus) Boca, Human coronavirus (HCoV), Mycoplasma pneumoniae (Mp) and Chlamydia (Ch). From the perspective of health economics, multiple PCR detection has strong specificity and high sensitivity, and can detect 13 pathogens at the same time, greatly shortening the time of such results, making the diagnosis more accurate, thus enabling clinicians to use more precise drugs, avoid the abuse of antibiotics, effectively shorten the hospitalization period of patients, improve the turnover rate of hospital beds, and reduce the hospitalization cost of patients. Savings in medical costs [ 13 ] . This study retrospectively analyzed the nucleic acids of 13 respiratory pathogens in 3 521 hospitalized children with acute respiratory infection treated in Qingyuan People's Hospital after after NPI were lifted, and analyzed the detection results. It is expected to help clinical early diagnosis and early treatment, precision medicine, so as to prevent antibiotic abuse, shorten the hospitalization period of patients, improve the bed turnover rate, and reduce the waste of medical resources. 2. Materials and Methods 2.1 Specimen collection A total of 3 521 hospitalized children with acute respiratory tract infection were included in the study from December 2022 to December 2023 in Qingyuan People's Hospital, of those2 223 males and 1 298 females ranged in age from 0 to 6 years old. The sample type was nasopharyngeal swab or sputum. 2.2 Methods 2.2.1 The principle of method Specific primers were designed for 13 respiratory pathogens. Multiple PCR technology was used to amplify multiple targets in a reaction tube at the same time, and then capillary electrophoresis was used to distinguish specific pathogens according to different lengths of amplified fragments. 2.2.2 Instruments and reagents The amplification instrument was purchased from Hangzhou Langi Scientific Instrument Co., LTD., the first generation sequencer ABI3500DX and supporting reagents such as DNA molecular length standard-500 (size-500), formamide solution (HiDi), separation glue, anode and cathode buffer were purchased from ABI Company. Nucleic acid extraction and purification reagent and multiple detection kit of 13 kinds of respiratory pathogens were purchased from Ningbo Health Gene Technologies Ltd.. 2.2.3 Sample collection The sample type was nasopharyngeal swab or sputum. Immediately after collection, the sample should be placed vertically in the ice bag, not tilted or overturned, and immediately submitted for inspection. If it cannot be detected immediately, the throat swab sample should be stored in a -20 ℃ refrigerator for no more than 3 days. 2.2.4 Pathogen DNA / RNA extraction The pathogen nucleic acid was extracted by magnetic bead method according to the instructions. After the extraction process, the nucleic acid in the last well was collected and needed to be amplified. 2.2.5 RT-PCR reaction 5 μL of the extracted nucleic acid was added to the 15 μL reverse recording system (14 μL premix + 1 μLRT-PCR enzyme solution). The corresponding amplification procedure was set in the PCR instrument according to the reagent instructions, and then the amplification was performed for 2 h 28 min, and the amplification product was stored for 4℃. 2.2.6 Capillary electrophoresis fragment analysis 9 μL AB Master Mix (Hi-Di ™ Formamide containing 2.5% SIZE-500) and 1 μL PCR product were added to the 96-well plate, and the corresponding specimen number and analysis method were set in the ABI-3500DX gene analyzer. After the detection is complete, the data is imported into the GENEMAPPER software for analysis, and the final detection result is obtained. 2.3 Statistical method Statistical analysis was performed using the SPSS17.0 software. The data were processed by using the Excel. Count data were expressed as n (%), and differences were compared using the χ 2 test, and P <0.05 was considered as statistically significant. 3. Results 3.1 Demographic Characteristics A total of 3521 hospitalized children diagnosed and treated with acute respiratory infections at Qingyuan People's Hospital from December 2022 to December 2023 were included. Among them, there were 2223 males and 1298 females; 1155 in the infant group (0–1 years old), 985 in the toddler group (1–3 years old), and 1381 cases in the preschool group (3–6 years old) (Table 1 ). Table 1 Demographic data of the hospitalized children admitted with ARIs Characteristics n Constituent ratio Age group (years) 0 ~ 1 962 35.79% 1 ~ 3 785 29.20% 3 ~ 6 941 35.01% Gender male 1708 63.54% female 980 36.46% 3.2 Overall Prevalence of Respiratory Pathogen Infection The results of 3 521 cases of acute respiratory infection were statistically analyzed. 2 306 cases were found to be positive for at least one pathogen, with a total positive rate of 65.49%. The highest positive detection rate was HRV, with a positive rate of 21.79% (768 / 3 521), followed by HRSV with 14.21% (501 / 3 521) and InfA (8.26%, 291 / 3 521) (Table 2 ). Table 2 Positive rates of 13 respiratory pathogens from December 2022 to December 2023 Respiratory tract pathogen Positive samples Positive rate HRV 768 21.79% HRSV 501 14.21% InfA 291 8.26% HPIV 276 7.83% Mp 262 7.43% HMPV 221 6.27% 09H1 202 5.73% HADV 175 4.96% H3 74 2.10% HCOV 68 1.93% Boca 68 1.93% InfB 47 1.33% Ch 24 0.68% 3.3 Gender -related Prevalence of Respiratory Pathogens Among the 3 521 samples, 1471 of the 2 223 male children were positive for at least one respiratory pathogen (including single infection and mixed infection), with a positive rate of 66.17%; 853 of 1 298 female children were positive for at least one respiratory pathogen(including single infection and mixed infection), with a positive rate of 64.33%. There was no significant difference in the detection rates of 13 respiratory pathogens in different genders ( P > 0.05) (Table 3 ). Table 3 Positive rates of 13 respiratory pathogens in different genders from December 2022 to December 2023 [n(%)] Respiratory tract pathogen male(n = 2 223) female(n = 1298) χ 2 值 P 值 InfA 195(8.77) 96(7.4) 2.046 0.153 09H1 135(6.07) 67(5.16) 1.258 0.262 H3 47(2.11) 26(2) 0.050 0.823 InfB 35(1.57) 12(0.92) 2.629 0.105 HPIV 161(7.24) 115(8.86) 2.967 0.085 HRSV 328(14.75) 173(13.33) 1.367 0.242 HADV 119(5.35) 56(4.31) 1.872 0.171 Mp 155(6.97) 105(8.09) 1.495 0.222 Ch 12(0.54) 12(0.92) 1.791 0.181 HRV 500(22.49) 268(20.65) 1.636 0.201 HMPV 129(5.8) 92(7.09) 2.300 0.129 HCOV 43(1.93) 25(1.93) 0.000 0.986 Boca 42(1.89) 26(2) 0.056 0.813 3.4 Age-related Prevalence of Respiratory Pathogens The 3 521 samples were divided into three age groups to analyze the infection of patients of different ages.Among them, the positive rate of respiratory pathogens in preschool group was the highest (987/1 381,71.47%), followed by the toddler group (694/985, 70.46%), and the infant group was the lowest (625/1155).The detection rate of HRSV was highest in the infant group, with a detection rate of 20.43% (236/1155).The detection rate of HRV was the highest in the infant group and preschool group, with the detection rate of 28.12% (277/985) and 21.80% (301/1381), respectively.Except for HPIV and HCOV, there were statistically significant differences in other pathogens among different age groups (P < 0.05) (Table 4 ). Table 4 Positive rates of 13 respiratory pathogens in different age groups from December 2022 to December 2023 [n(%)] Respiratory tract pathogen Infant (0–1 years old) toddler (1–3 years old) preschool (3–6 years old) χ 2 值 P 值 InfA 55(4.76) 64(6.5) 172(12.45)ab 54.728 0.000 09H1 42(3.64) 41(4.16) 119(8.62)ab 35.121 0.000 H3 11(0.95) 18(1.83) 44(3.19)ab 15.864 0.000 InfB 8(0.69) 8(0.81) 31(2.24)ab 14.341 0.001 HPIV 103(8.92) 80(8.12) 93(6.73)a 4.303 0.116 HRSV 236(20.43) 149(15.13)a 116(8.4)ab 75.527 0.000 HADV 12(1.04) 42(4.26)a 121(8.76)ab 80.867 0.000 Mp 26(2.25) 58(5.89)a 176(12.74)ab 105.740 0.000 Ch 18(1.56) 4(0.41)a 2(0.14)a 20.100 0.000 HRV 190(16.45) 277(28.12)a 301(21.8)ab 42.465 0.000 HMPV 49(4.24) 67(6.8)a 105(7.6)a 12.718 0.002 HCOV 15(1.3) 21(2.13) 32(2.32) 3.736 0.154 Boca 8(0.69) 40(4.06)a 20(1.45)b 34.645 0.000 Total positives 625 (54.11) 694 (70.46) 987 (71.47) 98.760 0.000 Note: a P <0.05,compared with the infant group; b P <0.05,compared with the toddler group. 3.5 Monthly Distribution According to the statistical analysis by month, the total detection rate of pathogens was the highest in April 2023, 80.71% (251/311),followed by December of the same year, 78.66% (199 / 253) and November,76.92% (210 / 273), and the difference in detection rate in different months was statistically significant ( χ 2 = 423.944, P < 0.05).The detection rate of InfA was the highest in April, 41.48% (129 / 311), followed by March ,24.52% (64 / 261),the detection rate of different months was statistically significant ( χ 2 = 707.091, P < 0.05);The detection rate of HRSV was the highest in May, 38.30% (149 / 389), followed by April, 26.69% (83 / 311),the detection rate of different months was statistically significant ( χ 2 = 360.229, P < 0.05);The detection rate of HRV was the highest in March, 35.63% (93 / 261), followed by November 34.43% (94 / 273), the detection rate of different months was statistically significant ((2 = 160.410, P < 0.05) (Fig. 1 ). 3.6 Analysis of the Major Pathogens of Community-acquired Pneumonia In this study, we found that of 3521 clinical diagnosis of ARI children aged 0 to 6 years, 1880 children were diagnosed with community-acquired pneumonia, accounting for 53.39%. Among them, 383 cases (20.37%) were positive for HRSV, 239 cases (12.71%) were positive for Mp, and 87 cases (4.63%) were positive for HADV. The detection rate of the three respiratory pathogens was statistically different ( χ 2 = 1418.00, P < 0.05). 4. Discussion Acute respiratory infections (ARIs) can cause many deaths around the world every year, especially in children. Because children are in the developmental stage, the functions of the respiratory system and immune system are not fully developed, and they are vulnerable to infection by a variety of pathogens, causing acute respiratory diseases, which is a common threat to public safety. Therefore, accurate and rapid identification of pathogens that cause acute respiratory infections is essential for accurate antiviral therapy and prevention of overuse of antibiotics. A total of 3521 children with acute respiratory tract infection were included in this study, the pathogen positive rate was 65.49%, and the main detection rates were HRV, HRSV and InfA. Min Gao [ 14 ] et al. found that 14.45% were positive for at least one pathogen.,among them HRSV was the most frequent pathogen, followed by HPIV, HADV,and MP, which was different from this study. The main types of prevalent pathogens are different, which may be related to various reasons such as the types of specimens included, the geographical location of different regions, climate, social factors, and so on. The children included in this study were more male than female, with a male to female ratio of 1.71:1. It has been reported [ 14 , 15 ] that boys are more likely to suffer from respiratory diseases than girls. In this study, there was no statistically significant difference between gender and respiratory pathogen infection, indicating that boys may not be related to susceptibility to respiratory virus infection. However, it has also been reported that boys are more susceptible to HRSV than girls. The relationship between gender and viral infection is complex and could be further studied in the future. The positive rate of children in different ages is different. In this study, the total positive rate of pathogens in the infant group is significantly lower than that in other groups, while the positive rate in the preschool group is the highest, which is consistent with the report in Chengdu [ 16 ] . The reason may be that after the epidemic is released, some prevention awareness during the epidemic still persists, and the opportunity for low-month-old babies to go out is far less than the opportunity for preschool children aged 3 to 6. The results of this study showed that the positive detection rate of MP, InfA, HADV and HMPV was the highest in preschool children,while the positive rate of HRSV in the infant group was as high as 20.43%, and the positive rate gradually decreased with the increase of age. Previous studies have also found a similar trend in HRSV infection [ 14 , 17 , 18 , 19 ] , which may be related to the continuous improvement of body immunity. The positive rate of respiratory pathogens was different in different months. In this study, the positive rate of respiratory pathogens showed a general upward trend with the distribution of each month. Among them, the virus detection rate in January is significantly lower than other months, one possible reason is that the Chinese Lunar New Year occurs in January, many children go home for the New Year as their families, and the population gathering in public places is significantly reduced. This is consistent with previous studies [ 9 ] . The positive rate reached the highest in April, possibly due to the influenza A virus epidemic in Qingyuan at that time, resulting in 80.71% positive rate of acute respiratory pathogens. The second is December, with a positive rate of 78.66%, which may be greatly related to the worsening of cold in December, the reduction of outdoor activities of many children, and the reduction of the frequency of ventilation by opening windows. That is consistent with findings reported in Spain, the USA [ 20 , 21 ] , and Shanghai, China [ 22 ] .Therefore, seasonal prevention is of great significance. In autumn and winter, when it is impossible to avoid school gatherings, hand hygiene awareness during the epidemic period, ventilation, wearing masks and other preventive measures can greatly reduce the risk of acute respiratory infection. Respiratory viruses are the main pathogens causing community-acquired pneumonia in infants and preschool children [ 23 – 25 ] . In this study, 53.39% of the diseases caused by acute respiratory infection were diagnosed as community-acquired pneumonia. Among them, the positive rate of children infected with HRSV was 20.37%, which was higher than that of children infected with MP and HADV. Because the mucosal barrier defense system of children aged 0 to 6 years is still underdeveloped, they are more susceptible to respiratory syncytial virus infection once they come into contact with secretions containing the virus. In view of the high incidence of HRSV in young children, it is recommended that infants and young children should be the focus of prevention work, such as children with high risk factors such as immune deficiency can be vaccinated as early as possible. In summary, different pathogens have different morbidity characteristics in different regions, different ages and different months. By analyzing the detection and epidemic characteristics of pathogens in children with acute respiratory infection, it is conducive to early clinical diagnosis and treatment, precision medicine and prevention of antibiotic abuse. At the same time, it also helps to guide the disease prevention and control in the region and reduce the waste of medical resources. Declarations Ethics approval and consent to participate This was a retrospective, observational study. This study has been approved by the Ethics Committee of The Affliated Qingyuan Hospital of Guangzhou Medical University (Clinical Trial Number : MR-44-23-045882; Ethics approval number: IRB-2023-163). Consent for publication Not applicable. Availability of data and material The data and materials supporting the conclusions of the study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Funding This study was supported by fund from the Guangdong Zhong Nanshan Medical Foundation research Fund(ZNSXS-20240010) Authors' contributions YWG,CB ,TG designed the research;CB,YJL,CC,QHX, ZMF performed the research and acquired data;CB,TG, LYM analyzed the data;CB,TG and YWG wrote the paper; XLQ and YWG revised the manuscript; YWG approved the final version to be published. All authors read and approved the final manuscript. Acknowledgements We gratefully thank to all patients who participated in this study, and thank our colleagues at the Affliated Qingyuan Hospital(Qingyuan People's Hospital), Guangzhou Medical University, for their support during the study. 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Cheng","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAx0lEQVRIiWNgGAWjYBACfvaGxAcJFWxyjO0NRGqR7Dnw2ODDGT5j5p4DRGoxuJH4THJmm1xi+4wEYm1pSE425m0zM+ad+XjjDYYam2iCWvgZjiU+5jmXJic5O63YguFYWm4DQVsae5KNecqOGRvOzjGTYGw4TFiLwWH+b9I8bP8T9988Q6yWYwxpkjPa2BIbZ/AQqUWyhyEZGMhsxow9QL8kEOMXfvkHsKg8vPHGhxobwlpQHCmRQIpyiBZSdYyCUTAKRsHIAABKIEQJJvBwrQAAAABJRU5ErkJggg==","orcid":"","institution":"The Affliated Qingyuan Hospital(Qingyuan People's Hospital), Guangzhou Medical University","correspondingAuthor":true,"prefix":"","firstName":"Bin","middleName":"","lastName":"Cheng","suffix":""},{"id":337642846,"identity":"e2ed62ef-d740-4e93-8759-50f774e133a6","order_by":1,"name":"Gang Tian","email":"","orcid":"","institution":"The Affliated Qingyuan Hospital(Qingyuan People's Hospital), Guangzhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Gang","middleName":"","lastName":"Tian","suffix":""},{"id":337642847,"identity":"0ccc388a-2ba0-4aca-a1ba-41ed6050dbb4","order_by":2,"name":"Jinlan Yang","email":"","orcid":"","institution":"Guangzhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Jinlan","middleName":"","lastName":"Yang","suffix":""},{"id":337642848,"identity":"bb5687f1-9d1b-4a36-b8d1-11082b45f2eb","order_by":3,"name":"Yanmei Liu","email":"","orcid":"","institution":"The Affliated Qingyuan Hospital(Qingyuan People's Hospital), Guangzhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Yanmei","middleName":"","lastName":"Liu","suffix":""},{"id":337642849,"identity":"437a2b85-c765-4e8e-a676-926ed6a0162d","order_by":4,"name":"Chen Chen","email":"","orcid":"","institution":"The Affliated Qingyuan Hospital(Qingyuan People's Hospital), Guangzhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Chen","middleName":"","lastName":"Chen","suffix":""},{"id":337642850,"identity":"d48b4791-6642-4c42-ba19-b3fecb320147","order_by":5,"name":"Huaxin Qi","email":"","orcid":"","institution":"The Affliated Qingyuan Hospital(Qingyuan People's Hospital), Guangzhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Huaxin","middleName":"","lastName":"Qi","suffix":""},{"id":337642851,"identity":"a9a65273-fd88-4376-835d-7991ba1e1652","order_by":6,"name":"Meifang Zhou","email":"","orcid":"","institution":"The Affliated Qingyuan Hospital(Qingyuan People's Hospital), Guangzhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Meifang","middleName":"","lastName":"Zhou","suffix":""},{"id":337642852,"identity":"ce6d811a-da9f-417b-b58b-ea82b80bbd71","order_by":7,"name":"Lingqing Xu","email":"","orcid":"","institution":"The Affliated Qingyuan Hospital(Qingyuan People's Hospital), Guangzhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Lingqing","middleName":"","lastName":"Xu","suffix":""},{"id":337642853,"identity":"24b9eca5-9f5d-4767-9c98-3ab73b9abcde","order_by":8,"name":"Weiguo Yin","email":"","orcid":"","institution":"The Affliated Qingyuan Hospital(Qingyuan People's Hospital), Guangzhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Weiguo","middleName":"","lastName":"Yin","suffix":""}],"badges":[],"createdAt":"2024-07-31 09:08:48","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4834028/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4834028/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":64602206,"identity":"41f7cd78-d134-4350-bf34-d89ff22511a3","added_by":"auto","created_at":"2024-09-16 12:20:05","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":29342,"visible":true,"origin":"","legend":"\u003cp\u003eMonthly distribution of positive rates of 13 respiratory pathogens\u003c/p\u003e\n\u003cp\u003efrom December 2022 to December 2023\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-4834028/v1/f6db22e56a9adc2732cfb8f8.png"},{"id":89740278,"identity":"aa20af8a-98b2-4516-a1ed-9fb7be05b837","added_by":"auto","created_at":"2025-08-23 19:31:26","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":959771,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4834028/v1/e7a1e4e1-c163-4c23-9ad5-cd6dc04f1d5c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Clinical study on the distribution of acute respiratory pathogens after the unsealing of COVID-19","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eAcute respiratory infections (ARI) are infectious diseases caused by one or more microorganisms such as viruses, bacteria, mycoplasma and chlamydia that invade the respiratory tract. They include the common cold, otitis media, acute bronchiolitis, pharyngitis and pneumonia. It is one of the leading causes of morbidity and mortality worldwide, especially among children \u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. Common pathogens causing ARI include viruses, bacteria and fungi, among which viruses are more common. Respiratory syncytial virus, parainfluenza virus, influenza virus and adenovirus are the main respiratory viruses infected by children \u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e. There are strict diagnostic criteria for the diagnosis of ARI, but empiric treatment is still common. The clinical symptoms of respiratory infections are often similar, and it is difficult to distinguish viral infections from bacterial infections based on symptoms \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e. Therefore, a better understanding of the epidemiological and clinical characteristics that lead to ARI is critical to the successful implementation of prevention, control and treatment strategies.\u003c/p\u003e \u003cp\u003eThe COVID-19 pandemic is having a huge impact on global health. To reduce the previously unknown transmission of SARS-CoV-2, preventive measures such as containment, keeping a safe distance, using masks and raising awareness of hand hygiene have been widely adopted \u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e. These non-pharmaceutical interventions (NPI), also known as public health measures or community mitigation strategies, are thought to be effective against the spread of other respiratory infections as well \u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. Within two weeks of the declaration of the COVID-19 epidemic in the United States in March 2020, influenza incidence in the United States suddenly declined \u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e. Subsequently, global surveillance studies also confirmed a significant reduction in the occurrence of influenza \u003csup\u003e[\u003cspan additionalcitationids=\"CR6 CR7\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e. Several retrospective studies have reported similar findings for other respiratory pathogens, such as syncytial virus, parainfluenza virus, and metapneumovirus \u003csup\u003e[\u003cspan additionalcitationids=\"CR9 CR10\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e. However, after the cancellation of NPI, respiratory syncytial virus surged in the summer, while parainfluenza virus and coronavirus are returning to pre-COVID-19 pandemic levels \u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eAt present, traditional immunological techniques are still the main detection techniques for respiratory pathogens in clinical practice, but its methodology has shortcomings such as low positive detection rate, the possibility of false positives, and the inability to distinguish between existing infections and past infections, thus affecting subsequent treatment. The multiple RT-PCR-capillary electrophoresis fragment analysis technology has the advantages of simultaneous detection of 13 kinds of respiratory pathogen nucleic acids through 1 specimen 1 time, triple quality control exclusion of specimens and false negatives caused by experimental process, and the use of UDG enzyme to prevent false positives caused by sample contamination, therefore, the positive detection rate of acute respiratory infection pathogens is high, 13 pathogens can be detected simultaneously ,including Influenza A virus (InfA, including subtypes 2009H1N1 and H3), Influenza B virus (InfB), Human respiratory syncytial virus (HRSV), Human parainfluenza virus (Human parainfluenza virus) HPIV, Human Metapneumovirus (HMPV), Human adenovirus (HADV), Human rhinovirus (HRV), Boca virus (Bocaparvovirus) Boca, Human coronavirus (HCoV), Mycoplasma pneumoniae (Mp) and Chlamydia (Ch). From the perspective of health economics, multiple PCR detection has strong specificity and high sensitivity, and can detect 13 pathogens at the same time, greatly shortening the time of such results, making the diagnosis more accurate, thus enabling clinicians to use more precise drugs, avoid the abuse of antibiotics, effectively shorten the hospitalization period of patients, improve the turnover rate of hospital beds, and reduce the hospitalization cost of patients. Savings in medical costs \u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThis study retrospectively analyzed the nucleic acids of 13 respiratory pathogens in 3 521 hospitalized children with acute respiratory infection treated in Qingyuan People's Hospital after after NPI were lifted, and analyzed the detection results. It is expected to help clinical early diagnosis and early treatment, precision medicine, so as to prevent antibiotic abuse, shorten the hospitalization period of patients, improve the bed turnover rate, and reduce the waste of medical resources.\u003c/p\u003e"},{"header":"2. Materials and Methods","content":"\u003cp\u003e\u003cstrong\u003e2.1\u003c/strong\u003e \u003cstrong\u003eSpecimen collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 3 521 hospitalized children with acute respiratory tract infection were included in the study from December 2022 to December 2023 in Qingyuan People's Hospital, of those2 223 males and 1 298 females ranged in age from 0 to 6 years old. The sample type was nasopharyngeal swab or sputum.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2 Methods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2.1 The principle\u003c/strong\u003e \u003cstrong\u003eof method\u0026nbsp;\u003c/strong\u003eSpecific primers were designed for 13 respiratory pathogens. Multiple PCR technology was used to amplify multiple targets in a reaction tube at the same time, and then capillary electrophoresis was used to distinguish specific pathogens according to different lengths of amplified fragments.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2.2 Instruments and reagents\u0026nbsp;\u003c/strong\u003eThe amplification instrument was purchased from Hangzhou Langi Scientific Instrument Co., LTD., the first generation sequencer ABI3500DX and supporting reagents such as DNA molecular length standard-500 (size-500), formamide solution (HiDi), separation glue, anode and cathode buffer were purchased from ABI Company. Nucleic acid extraction and purification reagent and multiple detection kit of 13 kinds of respiratory pathogens were purchased from\u0026nbsp;Ningbo Health Gene Technologies Ltd..\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2.3 Sample collection\u0026nbsp;\u003c/strong\u003eThe sample type was nasopharyngeal swab or sputum. Immediately after collection, the sample should be placed vertically in the ice bag, not tilted or overturned, and immediately submitted for inspection. If it cannot be detected immediately, the throat swab sample should be stored in a -20 ℃ refrigerator for no more than 3 days.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2.4 Pathogen DNA / RNA extraction\u0026nbsp;\u003c/strong\u003eThe pathogen nucleic acid was extracted by magnetic bead method according to the instructions. After the extraction process, the nucleic acid in the last well was collected and needed to be amplified.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2.5 RT-PCR reaction\u0026nbsp;\u003c/strong\u003e5\u0026nbsp;μL\u0026nbsp;of the extracted nucleic acid was added to the 15\u0026nbsp;μL\u0026nbsp;reverse recording system (14\u0026nbsp;μL\u0026nbsp;premix + 1\u0026nbsp;μLRT-PCR enzyme solution). The corresponding amplification procedure was \u0026nbsp;set in the PCR instrument according to the reagent instructions, and then the amplification was performed for 2 h 28 min, and the amplification product was stored for 4℃.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2.6 Capillary electrophoresis fragment analysis\u0026nbsp;\u003c/strong\u003e9\u0026nbsp;μL\u0026nbsp;AB Master Mix (Hi-Di ™ Formamide containing 2.5% SIZE-500) and 1\u0026nbsp;μL\u0026nbsp;PCR product were added to the 96-well plate, and the corresponding specimen number and analysis method were set in the ABI-3500DX gene analyzer. After the detection is complete, the data is imported into the GENEMAPPER software for analysis, and the final detection result is obtained.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3 Statistical method\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStatistical analysis was performed using the SPSS17.0 software. The data were processed by using the Excel. Count data were expressed as n (%), and differences were compared using the\u0026nbsp;χ\u003csup\u003e2\u003c/sup\u003e test, and \u003cem\u003eP\u0026nbsp;\u003c/em\u003e\u0026lt;0.05 was considered as statistically significant.\u003c/p\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Demographic Characteristics\u003c/h2\u003e \u003cp\u003eA total of 3521 hospitalized children diagnosed and treated with acute respiratory infections at Qingyuan People's Hospital from December 2022 to December 2023 were included. Among them, there were 2223 males and 1298 females; 1155 in the infant group (0\u0026ndash;1 years old), 985 in the toddler group (1\u0026ndash;3 years old), and 1381 cases in the preschool group (3\u0026ndash;6 years old) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic data of the hospitalized children admitted with ARIs\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eConstituent ratio\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge group (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u0026thinsp;~\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e962\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35.79%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u0026thinsp;~\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e785\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29.20%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u0026thinsp;~\u0026thinsp;6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e941\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35.01%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003emale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1708\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e63.54%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003efemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e980\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36.46%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Overall Prevalence of Respiratory Pathogen Infection\u003c/h2\u003e \u003cp\u003eThe results of 3 521 cases of acute respiratory infection were statistically analyzed. 2 306 cases were found to be positive for at least one pathogen, with a total positive rate of 65.49%. The highest positive detection rate was HRV, with a positive rate of 21.79% (768 / 3 521), followed by HRSV with 14.21% (501 / 3 521) and InfA (8.26%, 291 / 3 521) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePositive rates of 13 respiratory pathogens from December 2022 to December 2023\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRespiratory tract pathogen\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePositive samples\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePositive rate\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHRV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e768\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21.79%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHRSV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e501\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.21%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e291\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.26%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHPIV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e276\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.83%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMp\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e262\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.43%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHMPV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e221\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.27%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e09H1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e202\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.73%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHADV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e175\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.96%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eH3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.10%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHCOV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.93%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBoca\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.93%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.33%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.68%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Gender -related Prevalence of Respiratory Pathogens\u003c/h2\u003e \u003cp\u003eAmong the 3 521 samples, 1471 of the 2 223 male children were positive for at least one respiratory pathogen (including single infection and mixed infection), with a positive rate of 66.17%; 853 of 1 298 female children were positive for at least one respiratory pathogen(including single infection and mixed infection), with a positive rate of 64.33%. There was no significant difference in the detection rates of 13 respiratory pathogens in different genders (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePositive rates of 13 respiratory pathogens in different genders from December 2022 to December 2023 [n(%)]\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRespiratory tract pathogen\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003emale(n\u0026thinsp;=\u0026thinsp;2 223)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003efemale(n\u0026thinsp;=\u0026thinsp;1298)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e值\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e值\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e195(8.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e96(7.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.153\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e09H1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e135(6.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67(5.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.258\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.262\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eH3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47(2.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26(2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.050\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.823\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35(1.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12(0.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.629\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.105\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHPIV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e161(7.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e115(8.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.967\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.085\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHRSV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e328(14.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e173(13.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.367\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.242\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHADV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e119(5.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56(4.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.872\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.171\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMp\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e155(6.97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e105(8.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.495\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.222\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12(0.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12(0.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.791\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.181\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHRV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e500(22.49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e268(20.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.636\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.201\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHMPV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e129(5.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e92(7.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.129\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHCOV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e43(1.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25(1.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.986\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBoca\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e42(1.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26(2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.056\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.813\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Age-related Prevalence of Respiratory Pathogens\u003c/h2\u003e \u003cp\u003eThe 3 521 samples were divided into three age groups to analyze the infection of patients of different ages.Among them, the positive rate of respiratory pathogens in preschool group was the highest (987/1 381,71.47%), followed by the toddler group (694/985, 70.46%), and the infant group was the lowest (625/1155).The detection rate of HRSV was highest in the infant group, with a detection rate of 20.43% (236/1155).The detection rate of HRV was the highest in the infant group and preschool group, with the detection rate of 28.12% (277/985) and 21.80% (301/1381), respectively.Except for HPIV and HCOV, there were statistically significant differences in other pathogens among different age groups (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePositive rates of 13 respiratory pathogens in different age groups from December 2022 to December 2023 [n(%)]\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRespiratory tract pathogen\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInfant\u003c/p\u003e \u003cp\u003e(0\u0026ndash;1 years old)\u003c/p\u003e\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003etoddler\u003c/p\u003e \u003cp\u003e(1\u0026ndash;3 years old)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003epreschool\u003c/p\u003e \u003cp\u003e(3\u0026ndash;6 years old)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e值\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e值\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55(4.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64(6.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e172(12.45)ab\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e54.728\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e09H1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42(3.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41(4.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e119(8.62)ab\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e35.121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eH3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11(0.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18(1.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44(3.19)ab\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15.864\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8(0.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8(0.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31(2.24)ab\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14.341\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHPIV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e103(8.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80(8.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e93(6.73)a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.303\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.116\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHRSV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e236(20.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e149(15.13)a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e116(8.4)ab\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e75.527\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHADV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12(1.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42(4.26)a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e121(8.76)ab\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e80.867\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMp\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26(2.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58(5.89)a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e176(12.74)ab\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e105.740\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18(1.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4(0.41)a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(0.14)a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e20.100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHRV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e190(16.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e277(28.12)a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e301(21.8)ab\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e42.465\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHMPV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49(4.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67(6.8)a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e105(7.6)a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e12.718\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHCOV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15(1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21(2.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32(2.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.736\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.154\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBoca\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8(0.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40(4.06)a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20(1.45)b\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e34.645\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal positives\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e625\u003c/p\u003e \u003cp\u003e(54.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e694\u003c/p\u003e \u003cp\u003e(70.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e987\u003c/p\u003e \u003cp\u003e(71.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e98.760\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eNote:\u003csup\u003ea\u003c/sup\u003e\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05,compared with the infant group;\u003csup\u003eb\u003c/sup\u003e\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05,compared with the toddler group.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.5 Monthly Distribution\u003c/h2\u003e \u003cp\u003eAccording to the statistical analysis by month, the total detection rate of pathogens was the highest in April 2023, 80.71% (251/311),followed by December of the same year, 78.66% (199 / 253) and November,76.92% (210 / 273), and the difference in detection rate in different months was statistically significant (\u003cem\u003eχ\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;423.944, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).The detection rate of InfA was the highest in April, 41.48% (129 / 311), followed by March ,24.52% (64 / 261),the detection rate of different months was statistically significant (\u003cem\u003eχ\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;707.091, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05);The detection rate of HRSV was the highest in May, 38.30% (149 / 389), followed by April, 26.69% (83 / 311),the detection rate of different months was statistically significant (\u003cem\u003eχ\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;360.229, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05);The detection rate of HRV was the highest in March, 35.63% (93 / 261), followed by November 34.43% (94 / 273), the detection rate of different months was statistically significant ((2\u0026thinsp;=\u0026thinsp;160.410, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e3.6 Analysis of the Major Pathogens of Community-acquired Pneumonia\u003c/h2\u003e \u003cp\u003eIn this study, we found that of 3521 clinical diagnosis of ARI children aged 0 to 6 years, 1880 children were diagnosed with community-acquired pneumonia, accounting for 53.39%. Among them, 383 cases (20.37%) were positive for HRSV, 239 cases (12.71%) were positive for Mp, and 87 cases (4.63%) were positive for HADV. The detection rate of the three respiratory pathogens was statistically different (\u003cem\u003eχ\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;1418.00, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eAcute respiratory infections (ARIs) can cause many deaths around the world every year, especially in children. Because children are in the developmental stage, the functions of the respiratory system and immune system are not fully developed, and they are vulnerable to infection by a variety of pathogens, causing acute respiratory diseases, which is a common threat to public safety. Therefore, accurate and rapid identification of pathogens that cause acute respiratory infections is essential for accurate antiviral therapy and prevention of overuse of antibiotics.\u003c/p\u003e \u003cp\u003eA total of 3521 children with acute respiratory tract infection were included in this study, the pathogen positive rate was 65.49%, and the main detection rates were HRV, HRSV and InfA. Min Gao \u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e et al. found that 14.45% were positive for at least one pathogen.,among them HRSV was the most frequent pathogen, followed by HPIV, HADV,and MP, which was different from this study. The main types of prevalent pathogens are different, which may be related to various reasons such as the types of specimens included, the geographical location of different regions, climate, social factors, and so on.\u003c/p\u003e \u003cp\u003eThe children included in this study were more male than female, with a male to female ratio of 1.71:1. It has been reported \u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e that boys are more likely to suffer from respiratory diseases than girls. In this study, there was no statistically significant difference between gender and respiratory pathogen infection, indicating that boys may not be related to susceptibility to respiratory virus infection. However, it has also been reported that boys are more susceptible to HRSV than girls. The relationship between gender and viral infection is complex and could be further studied in the future.\u003c/p\u003e \u003cp\u003eThe positive rate of children in different ages is different. In this study, the total positive rate of pathogens in the infant group is significantly lower than that in other groups, while the positive rate in the preschool group is the highest, which is consistent with the report in Chengdu \u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e. The reason may be that after the epidemic is released, some prevention awareness during the epidemic still persists, and the opportunity for low-month-old babies to go out is far less than the opportunity for preschool children aged 3 to 6. The results of this study showed that the positive detection rate of MP, InfA, HADV and HMPV was the highest in preschool children,while the positive rate of HRSV in the infant group was as high as 20.43%, and the positive rate gradually decreased with the increase of age. Previous studies have also found a similar trend in HRSV infection \u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e, which may be related to the continuous improvement of body immunity.\u003c/p\u003e \u003cp\u003eThe positive rate of respiratory pathogens was different in different months. In this study, the positive rate of respiratory pathogens showed a general upward trend with the distribution of each month. Among them, the virus detection rate in January is significantly lower than other months, one possible reason is that the Chinese Lunar New Year occurs in January, many children go home for the New Year as their families, and the population gathering in public places is significantly reduced. This is consistent with previous studies \u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e. The positive rate reached the highest in April, possibly due to the influenza A virus epidemic in Qingyuan at that time, resulting in 80.71% positive rate of acute respiratory pathogens. The second is December, with a positive rate of 78.66%, which may be greatly related to the worsening of cold in December, the reduction of outdoor activities of many children, and the reduction of the frequency of ventilation by opening windows. That is consistent with findings reported in Spain, the USA \u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e, and Shanghai, China \u003csup\u003e[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e.Therefore, seasonal prevention is of great significance. In autumn and winter, when it is impossible to avoid school gatherings, hand hygiene awareness during the epidemic period, ventilation, wearing masks and other preventive measures can greatly reduce the risk of acute respiratory infection.\u003c/p\u003e \u003cp\u003eRespiratory viruses are the main pathogens causing community-acquired pneumonia in infants and preschool children \u003csup\u003e[\u003cspan additionalcitationids=\"CR24\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e. In this study, 53.39% of the diseases caused by acute respiratory infection were diagnosed as community-acquired pneumonia. Among them, the positive rate of children infected with HRSV was 20.37%, which was higher than that of children infected with MP and HADV. Because the mucosal barrier defense system of children aged 0 to 6 years is still underdeveloped, they are more susceptible to respiratory syncytial virus infection once they come into contact with secretions containing the virus. In view of the high incidence of HRSV in young children, it is recommended that infants and young children should be the focus of prevention work, such as children with high risk factors such as immune deficiency can be vaccinated as early as possible.\u003c/p\u003e \u003cp\u003eIn summary, different pathogens have different morbidity characteristics in different regions, different ages and different months. By analyzing the detection and epidemic characteristics of pathogens in children with acute respiratory infection, it is conducive to early clinical diagnosis and treatment, precision medicine and prevention of antibiotic abuse. At the same time, it also helps to guide the disease prevention and control in the region and reduce the waste of medical resources.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis was a retrospective, observational study. This study has been approved by the Ethics Committee of The Affliated Qingyuan Hospital of Guangzhou Medical University (Clinical Trial Number : MR-44-23-045882; Ethics approval number: IRB-2023-163).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data and materials supporting the conclusions of the study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was supported by fund from the Guangdong Zhong Nanshan Medical Foundation research Fund(ZNSXS-20240010)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eYWG,CB ,TG designed the research;CB,YJL,CC,QHX, ZMF performed the research and acquired data;CB,TG, LYM analyzed the data;CB,TG and YWG wrote the paper; XLQ and YWG revised the manuscript; YWG approved the final version to be published. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe gratefully thank to all patients who participated in this study, and thank our colleagues at the Affliated Qingyuan Hospital(Qingyuan People's Hospital), Guangzhou Medical University, for their support during the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u0026nbsp;\u003c/sup\u003eThe Affliated Qingyuan Hospital(Qingyuan People's Hospital), Guangzhou Medical University,Qingyuan, Guangdong, China, 511518;\u003csup\u003e2\u003c/sup\u003e Kingmed School of Laboratory Medicine, Guangzhou Medical University,Guangzhou,Guangdong, China, 510000;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHe C, Liu L, Chu Y, et al: National and subnational all-cause and cause-specific child mortality in China, 1996\u0026ndash;2015: a systematic analysis with implications for the Sustainable Development Goals. The Lancet Global Health. 2017, 5(2):e186-e197.\u003c/li\u003e\n\u003cli\u003eEchavarria M, Marcone DN, Querci M, et al\u003cem\u003e.\u003c/em\u003e Clinical impact of rapid molecular detection of respiratory pathogens in patients with acute respiratory infection. \u003cem\u003eJ Clin Virol\u003c/em\u003e. 2018, 108:90\u0026ndash;95.\u003c/li\u003e\n\u003cli\u003eLee BR, Hassan F, Jackson MA, et al\u003cem\u003e.\u003c/em\u003e Impact of multiplex molecular assay turn-around-time on antibiotic utilization and clinical management of hospitalized children with acute respiratory tract infections. \u003cem\u003eJ Clin Virol\u003c/em\u003e.2019, 110:11\u0026ndash;16. \u003c/li\u003e\n\u003cli\u003eImai N, Gaythorpe KAM, Abbott S, et al. Adoption and impact of non-pharmaceutical interventions for COVID-19.\u003cem\u003eWellcome Open Res\u003c/em\u003e. 2020 5:59. \u003c/li\u003e\n\u003cli\u003eHuang QS, Wood T, Jelley L, et al.Impact of the COVID-19 nonpharmaceutical interventions on influenza and other respiratory viral infections in New Zealand.\u003cem\u003e Nat Commun.\u003c/em\u003e 2021 12(1):1001. \u003c/li\u003e\n\u003cli\u003eOlsen SJ, Azziz-Baumgartner E, Budd AP, et al. Decreased influenza activity during the COVID-19 Pandemic\u0026mdash;United States,Australia, Chile, and South Africa, 2020. \u003cem\u003eAm J Transplant\u003c/em\u003e. 2020,20(12):3681-3685.\u003c/li\u003e\n\u003cli\u003eFricke LM, Gl\u0026ouml;ckner S, Dreier M, et al. Impact of non-pharmaceutical interventions targeted at COVID-19 pandemic on influenza burden\u0026mdash;a systematic review. \u003cem\u003eJ Infection.\u003c/em\u003e 2021, 82(1):1\u0026ndash;35. \u003c/li\u003e\n\u003cli\u003eYeoh DK, Foley DA, Minney-Smith CA, et al. Impact of coronavirus disease 2019 public health measures on detections of influenza and respiratory syncytial virus in children during the 2020 AustralianWinter. \u003cem\u003eClin Infect Dis\u003c/em\u003e. 2021, 72(12):2199\u0026ndash;2202. \u003c/li\u003e\n\u003cli\u003eZhang Y, Qiao L, Yao J, et al. Epidemiological and clinical characteristics of respiratory viruses in 4403 pediatric patients from multiple hospitals in Guangdong, China. \u003cem\u003eBMC Pediatr\u003c/em\u003e. 2021, 21(1):284. \u003c/li\u003e\n\u003cli\u003eGroves HE, Pich\u0026eacute;-Renaud P-P, Peci A, et al.The impact of the COVID-19 pandemic on influenza, respiratory syncytial virus, and other seasonal respiratory virus circulation in Canada: a population-based study. \u003cem\u003eLancet Reg Health Am\u003c/em\u003e. 2021, 1:100015. \u003c/li\u003e\n\u003cli\u003eAvadhanula V, Piedra PA. The prevention of common respiratory virus epidemics in 2020-21 during the severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) Pandemic: an unexpected benefit of the implementation of public health measures. \u003cem\u003eLancet Reg Health Am\u003c/em\u003e. 2021, 2:100043.\u003c/li\u003e\n\u003cli\u003eOlsen SJ, Winn AK, Budd AP, et al. Changes in influenza and other respiratory virus activity during the COVID-19 pandemic \u0026mdash; United States. 2020\u0026ndash;2021.\u003cem\u003eMMWR\u003c/em\u003e 2021,70(29):1013\u0026ndash;1019\u003c/li\u003e\n\u003cli\u003eKitano T, Nishikawa H, Suzuki R, et al. The impact analysis of a multiplex PCR respiratory panel for hospitalized pediatric respiratory infections in Japan[J]. \u003cem\u003eJ Infect Chemother\u003c/em\u003e, 2020, 26(1): 82-85. \u003c/li\u003e\n\u003cli\u003eMin Gao, Xing Yao, Wei Mao Etiological analysis of virus, mycoplasma pneumoniae and chlamydia pneumoniae in hospitalized children with acute respiratory infections in Huzhou [J]. Virology Journal, 2020, 17: 119.\u003c/li\u003e\n\u003cli\u003eShi P, Zhang X, Liu L,et al. Age and gender-specifical trends in resptratory outpatient visits and diagnoses at a tertiary pediatric hospital in China:a 10-year retrospective study[J]. \u003cem\u003eBMC pediatrics\u003c/em\u003e, 2020,20(1):115-125\u003c/li\u003e\n\u003cli\u003eChen J， Hu P， Zhou T， et al. Epidemiology and clinical characteristics of acute respiratory tract infections among hospitalized infants and young children in Chengdu,West China, 2009－2014[J]\u003cem\u003e.BMC pediatrics\u003c/em\u003e, 2018,18(1):216.\u003c/li\u003e\n\u003cli\u003eWang H, Zheng Y, Deng J, Wang W, Liu P, Yang F, et al. Prevalence of respiratory viruses among children hospitalized from respiratory infections in Shenzhen, China. Virol J. 2016;13(1):39\u0026ndash;43\u003c/li\u003e\n\u003cli\u003eLiu T, Li Z, Zhang S, Song S, Julong W, Lin Y, et al. Viral Etiology of acute respiratory tract infections in hospitalized children and adults in Shandong Province, China. Virol J. 2015;12(1):168\u0026ndash;74\u003c/li\u003e\n\u003cli\u003eKurskaya O, Ryabichenko T, Leonova N, Shi W, Bi H, Sharshov K, et al. Viral etiology of acute respiratory infections in hospitalized children in Novosibirsk City, Russia (2013 - 2017). PLoS One. 2018;13(9):e0200117..\u003c/li\u003e\n\u003cli\u003eChoe YJ, Park S, Michelow IC: Co-seasonality and co-detection of respiratory viruses and bacteraemia in children: a retrospective analysis. Clin Microbiol Infect. 2020; 26:1690.e5-e8\u003c/li\u003e\n\u003cli\u003eSmithgall M, Maykowski P, Zachariah P, Oberhardt M, Vargas CY, Reed C, LaRussa P, Saiman L, Stockwell MS: Epidemiology, clinical features, and resource utilization associated with respiratory syncytial virus in the community and hospital. Influenza Other Respir Viruses. 2020; 14(3):247\u0026ndash;56\u003c/li\u003e\n\u003cli\u003eLiu P, Xu M, He L, Su L, Wang A, Fu P, Lu L, Wang C, Xu J: Epidemiology of Respiratory Pathogens in Children with Lower Respiratory Tract Infections in Shanghai, China, from 2013 to 2015. Jpn J Infect Dis. 2018; 71(1):39\u0026ndash;44\u003c/li\u003e\n\u003cli\u003eNolan VG, Arnold SR, Bramley AM, Ampofo K, Williams DJ, Grijalva CG, et al. Etiology and impact of coinfections in children hospitalized with community-acquired pneumonia. J Infect Dis. 2018;218:179-188.\u003c/li\u003e\n\u003cli\u003eRhedin S, Lindstrand A, Hjelmgren A, Ryd-Rinder M, \u0026Ouml;hrmalmL, Tolfvenstam T, et al. Respiratory viruses associated with community-acquired pneumonia in children: matched casecontrol study. Thorax. 2015;70:847-853.\u003c/li\u003e\n\u003cli\u003eBhuiyan MU, Snelling TL, West R, Lang J, Rahman T, Granland C, et al. The contribution of viruses and bacteria to community-acquired pneumonia in vaccinated children: a casecontrol study. Thorax. 2019;74:261-269.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Acute respiratory tract infection, Epidemiology, Multiplex-PCR, Influenza virus, Respiratory syncytial virus","lastPublishedDoi":"10.21203/rs.3.rs-4834028/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4834028/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo analyze the distribution characteristics of pathogen infection in patients with acute respiratory tract infection in our hospital, in order to understand the etiology and epidemiological traits of respiratory pathogen infection in Qingyuan area of Guangdong Province after the epidemic, and provide reference for clinical diagnosis and treatment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData of multiple RT-PCR and capillary electrophoresis fragment analysis were collected from hospitalized children aged 0-6 years who were diagnosed and treated for acute respiratory tract infection in Qingyuan People's Hospital from December 2022 to December 2023, and the results were statistically analyzed by SPSS 17.0.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe total positive rate of acute respiratory pathogen infection was 65.49% (2306/3521), and the highest positive rate was HRV (21.81%), followed by HRSV (14.23%, 501/3521) and InfA (8.26%, 291/3521). The positive rate of at least one pathogen in male children was 73.77% (1 640/2223), as in female children was 72.88% (946/1298). The positive rate of respiratory pathogens in preschool children group was 71.47%(987/1381),which was higher than in the early childhood group (694/985,70.46%) and in the babyhood group(625/1155,54.11%), and the difference was statistically significant(\u003cem\u003ec\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e=98.760，\u003cem\u003eP\u0026lt;\u003c/em\u003e0.001).The positive rate of respiratory pathogens was highest in April(80.71%,251/311),then were in December 2023 (78.66%,199/253) and in November(76.92%,210/273), and the difference was statistically significant(\u003cem\u003ec\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e=423.944，\u003cem\u003eP\u0026lt;\u003c/em\u003e0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe main pathogens of acute respiratory tract infection in our hospital are HRV, HRSV and InfA. The positive rate of males is higher than that of females, and the positive rate of preschool children is higher. There is a high incidence of infection during the winter and spring changes.\u003c/p\u003e","manuscriptTitle":"Clinical study on the distribution of acute respiratory pathogens after the unsealing of COVID-19","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-09-16 12:20:00","doi":"10.21203/rs.3.rs-4834028/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3495f487-9cce-417a-a121-c522a12bd213","owner":[],"postedDate":"September 16th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-08-23T19:23:12+00:00","versionOfRecord":[],"versionCreatedAt":"2024-09-16 12:20:00","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4834028","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4834028","identity":"rs-4834028","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}