Epidemiological trends and serological profiles of respiratory pathogens in Guangzhou: an 11-year retrospective study from 2013 to 2023.

BACKGROUND

Respiratory pathogens pose significant public health challenges globally, particularly in densely populated urban areas. This study aimed to analyze the epidemiological trends of multiple respiratory pathogens in Guangzhou, China, from 2013 to 2023, and investigate associated serological profiles to inform clinical management and public health interventions.

METHODS

We conducted a retrospective analysis of 96,927 cases with suspected respiratory infections (SRIs) (defined by fever >37.5 ℃, cough, dyspnea, and/or chest pain) at The First Affiliated Hospital of Guangzhou Medical University. Clinical data were extracted from electronic medical records, and immunofluorescence assays were used to detect immunoglobulin M (IgM) antibodies against nine respiratory pathogens.

RESULTS

Of the cases analyzed, 18.01% (17,454/96,927) tested serologically positive for at least one respiratory pathogen. Mycoplasma pneumoniae (MP) was the predominant pathogen (76.51% of serologically positive cases), followed by parainfluenza viruses (PIVS) (9.75%). The highest serologically positive rate was observed in the 5-14 age group (36.01%). Females exhibited a significantly higher overall serologically positive rate (21.30%) compared to males (15.97%, P<0.001). Serological analysis revealed profiles in confirmed infections, with significantly lower coagulation-related parameters (P<0.001) and some elevated inflammatory markers compared to suspected cases.

CONCLUSIONS

This comprehensive study provides crucial insights into the changing landscape of respiratory pathogen infections in Guangzhou over an 11-year period. The predominance of MP, particularly among school-age children and females, highlights the need for targeted interventions. The unexpected coagulation profiles in confirmed infections suggest complex pathophysiological mechanisms that warrant further investigation. These findings have important implications for clinical management, diagnostic approaches, and public health strategies in urban settings.