Journal of infection and public health · 2026
Respiratory pathogen dynamics in hospitalized children with lower respiratory tract infections: A 9-year hospital-based surveillance study in Beijing, China.
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Li Yanan, Kang Xuekai, Deng Zhuo, Xu Xin, Xi Yue, Sun Hongguo, Xie Zhengde, Ning Xue, Zhao Chengsong, Liu Gang
Аннотация
BACKGROUND: Lower respiratory tract infections (LRTIs) are a major cause of pediatric hospitalization. However, long-term, region-specific pediatric inpatient data remain limited on whether pathogen-specific seasonal patterns have returned to their baselines before nonpharmaceutical interventions (NPIs) or remain reconfigured.
METHODS: Using routinely collected, deduplicated PCR results from a hospital-based multi-pathogen surveillance system, we conducted a retrospective analysis of children hospitalized with LRTIs from January 2017 to December 2025. Pathogen-specific detection rates were calculated for each pathogen among children tested. We assessed changes in detection rates, age distribution, and monthly seasonal activity across the pre-NPI (2017-2019), NPI (2020-2022), and post-NPI periods (2023-2025), with particular focus on whether post-NPI seasonal detection patterns returned to the pre-NPI baseline or remained reconfigured. Pathogens included influenza A and B viruses (Flu A/B), respiratory syncytial virus (RSV), parainfluenza viruses (PIV), adenovirus (ADV), Mycoplasma pneumoniae (M. pneumoniae), and Chlamydia pneumoniae (C. pneumoniae).
RESULTS: After deduplication, the analysis included 39,343 Flu A, 39,024 Flu B, 37,283 PIV, 38,410 ADV, 36,826 RSV, 34,424 M. pneumoniae, and 32,703 C. pneumoniae PCR results were analyzed. By the end of 2025, there was no statistical evidence that the overall detection rates of M. pneumoniae or influenza viruses differed from the 2017-2019 baseline. In seasonal analyses, monthly detection patterns for M. pneumoniae, ADV, and PIV during the post-NPIs period were not significantly different from those during the baseline period, while RSV and influenza viruses continued to exhibit altered seasonal activity. Moreover, the age distribution of M. pneumoniae-, RSV-, PIV-, ADV-, and influenza virus-associated LRTIs showed a trend toward older children during the post-NPI period.
CONCLUSION: The nonuniform and asynchronous post-NPI recovery of common respiratory pathogens, accompanied by shifts toward older children for several pathogens, underscores the need for sustained local multi-pathogen surveillance to support early warning and timely public health responses.
METHODS: Using routinely collected, deduplicated PCR results from a hospital-based multi-pathogen surveillance system, we conducted a retrospective analysis of children hospitalized with LRTIs from January 2017 to December 2025. Pathogen-specific detection rates were calculated for each pathogen among children tested. We assessed changes in detection rates, age distribution, and monthly seasonal activity across the pre-NPI (2017-2019), NPI (2020-2022), and post-NPI periods (2023-2025), with particular focus on whether post-NPI seasonal detection patterns returned to the pre-NPI baseline or remained reconfigured. Pathogens included influenza A and B viruses (Flu A/B), respiratory syncytial virus (RSV), parainfluenza viruses (PIV), adenovirus (ADV), Mycoplasma pneumoniae (M. pneumoniae), and Chlamydia pneumoniae (C. pneumoniae).
RESULTS: After deduplication, the analysis included 39,343 Flu A, 39,024 Flu B, 37,283 PIV, 38,410 ADV, 36,826 RSV, 34,424 M. pneumoniae, and 32,703 C. pneumoniae PCR results were analyzed. By the end of 2025, there was no statistical evidence that the overall detection rates of M. pneumoniae or influenza viruses differed from the 2017-2019 baseline. In seasonal analyses, monthly detection patterns for M. pneumoniae, ADV, and PIV during the post-NPIs period were not significantly different from those during the baseline period, while RSV and influenza viruses continued to exhibit altered seasonal activity. Moreover, the age distribution of M. pneumoniae-, RSV-, PIV-, ADV-, and influenza virus-associated LRTIs showed a trend toward older children during the post-NPI period.
CONCLUSION: The nonuniform and asynchronous post-NPI recovery of common respiratory pathogens, accompanied by shifts toward older children for several pathogens, underscores the need for sustained local multi-pathogen surveillance to support early warning and timely public health responses.