川东北儿童非细菌性呼吸道病原体流行病学研究

Background ?Since the end of the large-scale epidemic of the COVID-19 epidemicdata from CDC surveillance and paediatric clinics suggest that the prevalence of respiratory infections in children has changed compared with the pastthat regional prevalence statistics are of directional significance for the diagnosis and treatment of respiratory infections in childrenand that large sample analyses of the epidemiology of children's respiratory pathogens in the northeast region of Sichuan Province are still rare. Objective ?The objective of this study is to ascertain the prevalence of 13 respiratory nonbacterial pathogens in children in three areas of northeastern Sichuan ProvinceBazhongNanchong and Guang'anfollowing the outbreakwith a view to providing a basis for the prevention and treatment of respiratory infections in clinical children. Methods ?A retrospective analysis of pathogen samples from 15 772 children diagnosed with acute respiratory tract infections and hospitalised in Bazhong Central HospitalNanchong Central Hospital and Guang'an People's Hospital between 7 December 2022 and 30 June 2024 was conducted. Of these8 70755.2%were male and 7 06544.8%were female. The subjects were divided into four groups according to their age groupsinfant group<1 year old3 938 casestoddler group1~<3 years old6 434 casespreschool group3~<6 years old3 231 casesand school-age group6~14 years old 2 169 cases. The onset of the disease was categorised according to the seasonwith 15 772 cases divided as follows5 423 cases in the springMarch to May2 594 cases in the summerJune to August3 121 cases in the autumnSeptember to Novemberand 4 634 cases in the winterDecember to February. A total of 13 non-bacterial pathogensincluding influenza A virusinfluenza A virus H1N1influenza A virus H3N2influenza B virusparainfluenza virusMycoplasma pneumoniaechlamydiaparapneumovirusrespiratory syncytial virusadenovirusrhinovirusbocavirus and coronaviruswere detected using the multiplex reverse transcription polymerase chain reaction technique. The subsequent investigation focused on the detection of pathogens in the total samplewith the positive detection rate of each pathogen being compared among different regionsgendersage groups and seasons. Results ?Of the 15772 respiratory samples1161873.66%were positive for pathogenswhile 363223.03%were identified as mixed infections. The most prevalent pathogens identified were rhinovirus24.5%respiratory syncytial virus16.4%Mycoplasma pneumoniae13.8%influenza A virus9.4%and parainfluenza virus8.9%. The total detection rates of pathogens in samples from the BazhongNanchong and Guang'an regions were 80.9%73.7%and 75.3%respectively. The difference in the total detection rates of pathogens in samples from the three regions was statistically significant when comparing the rates of pathogens in samples from the three regions2 =101.119P<0.001. The total detection rate of pathogens in samples from boys72.1%was lower than that of girls75.6% 2 =24.539P0.05. A statistically significant difference was observed when the total detection rates of pathogens in samples from the infanttoddlerpreschool and school-age groups were compared2 =174.613P<0.001. Among the 13 pathogenswith the exception of coronavirusstatistically significant differences were identified when the detection rates of the remaining pathogens were compared among different age groupsP<0.05. Furthermorea comparison of the total detection rates of pathogens in samples collected during different seasonsspringsummerautumn and winterrevealed a statistically significant difference2 =364.584P<0.001. Notablythe winter samples exhibited the highest total detection rate of pathogens80.0%while the spring samples exhibited the lowest72.3%. Conclusion ?In the 18 months after the COVID-19 outbreak was unsealedthe main pathogens of acute respiratory infections in children in the three regions of northeast Sichuan were rhinovirusrespiratory syncytial virusMycoplasma pneumoniaeinfluenza A virus and parainfluenza virusand the epidemiology varied by region. Among the 13 pathogensexcept for coronavirusesthere was no difference in the detection rate among different genders but there were differences between age and seasonal subgroups. COVID-19 had some impact on the prevalence of other pathogens.