Analysis of pathogen spectrum of respiratory tract infection in children in Handan before and after COVID-19

YANG Jianfeng; XUE Huimin; DONG Zhiling

doi:10.3969/j.issn.1002-7386.2025.12.033

Abstract：Objective To explore the changes in pathogen spectrum of children with respiratory tract infection in Handan City before and after COVID-19.Methods A total of 46,613 children aged 29 days to 14 years with respiratory tract infection from January 2018 to December 2023 were retrospectively analyzed.Nine respiratory pathogens,including respiratory syncytial virus,adenovirus,influenza B virus,influenza A virus,parainfluenza virus,mycoplasma pneunoniae,chlamydia pneumoniae,coxiella burnetii and Legionella pneumophila were examined.Three time periods were set:from January 2018 to December 2019(before COVID-19),from January 2020 to December 2022(during COVID-19),and from January 2023 to December 2023(COVID-19 as a Class B infectious disease managed by Class B interventions).The changes in pathogen spectrum were analyzed.Results At least one pathogen was detected in 24,661 out of the 46,613 children,with a positive rate of 52.91％.The top three pathogens were mycoplasma pneumoniae,influenza A virus and respiratory syncytial virus,with the detection rate of 21.97％,13.47％and 6.26％,respectively.The pathogen detection rate was 53.82％(14,056/26,117)in male children,and 53.16％(10,736/20,196)in female children,without a significant difference(P=0.158).The pathogen detection rate of inpatients was significantly higher than that in outpatients(54.53％[19,299/35,391]vs 48.95％[5,493/11,222],P＜0.001).The detection rates of pathogens were different in different seasons.Respiratory syncytial virus,influenza A virus and influenza B virus were the main pathogens in winter.The detection rate of Legionella pneumophila was the highest in summer and autumn,adenovirus was the highest in spring and summer,and that of mycoplasma pneunoniae and chlamydia pneumoniae was the lowest in summer.The detection rate of pathogens before COVID-19,during COVID-19 and after COVID-19 was considered as a Class B infectious disease and managed by Class B interventions was 55.67％,45.77％and 60.39％,respectively.Conclusion The detection rate of pathogens during COVID-19 is significantly lower than that before COVID-19,and the detection rate of pathogens after it has been considered as a Class B infectious disease and managed by Class B interventions is significantly higher than that before and during COVID-19,and the detection rate of pathogen spectrum differs in different seasons.We should fully understand the physical detection of pathogens in the current region,which is conducive to targeted preventive measures and treatment for children.