Diagnostic microbiology and infectious disease · 2025
Mixed respiratory infections in symptomatic outpatients: A study in community health settings.
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Liao Jiaman, Huang Xueliang, Huang Hao, Shen Cuina, Li Jing, Zhai Haiting, Zhan Yiqiang, Wang Lingwei
Аннотация
BACKGROUND: Mixed respiratory infections in individuals with respiratory symptoms in primary care settings are understudied. This study aims to investigate their epidemiology and determinants.
METHODS: A cross-sectional study was conducted with 244 consecutive adult patients with respiratory symptoms at Nanlian Community Health Center (January-March 2024). Throat swabs were analyzed for 18 respiratory pathogens and SARS-CoV-2 using multiplex PCR. Hematological parameters, including neutrophil-to-lymphocyte ratio (NLR), were measured from blood counts. The primary outcome was infection status (uninfected, single, or mixed). Multinomial logistic regression models identified factors associated with infection patterns.
RESULTS: The initial cohort included 294 patients and 5,292 pathogen test results, with 319 (6.0 %) positive for at least one of 18 targeted pathogens. The most common pathogens in mixed infections were Influenza A Virus (25.1 %), H3N2 (23.5 %), and Haemophilus influenzae (22.3 %). After excluding 50 cases with incomplete questionnaires, the analytical cohort consisted of 244 participants (83.0 % of total), 56.1 % of whom were female. The largest age group was 19-40 years (71.3 %), and 65 participants (26.6 %) had mixed infections. Higher symptom counts (adjusted OR=1.700, 95 % CI 1.346-2.147) and elevated NLR (adjusted OR=1.232, 95 % CI 1.068-1.422) were linked to mixed infections. SARS-CoV-2 co-infection was negatively associated with mixed infections (adjusted OR=0.141, 95 % CI 0.035-0.575).
CONCLUSIONS: Mixed infections correlate with greater symptom burden and higher inflammation markers. The inverse relationship with SARS-CoV-2 warrants further investigation. Findings support targeted pathogen testing in symptomatic patients with elevated NLR.
METHODS: A cross-sectional study was conducted with 244 consecutive adult patients with respiratory symptoms at Nanlian Community Health Center (January-March 2024). Throat swabs were analyzed for 18 respiratory pathogens and SARS-CoV-2 using multiplex PCR. Hematological parameters, including neutrophil-to-lymphocyte ratio (NLR), were measured from blood counts. The primary outcome was infection status (uninfected, single, or mixed). Multinomial logistic regression models identified factors associated with infection patterns.
RESULTS: The initial cohort included 294 patients and 5,292 pathogen test results, with 319 (6.0 %) positive for at least one of 18 targeted pathogens. The most common pathogens in mixed infections were Influenza A Virus (25.1 %), H3N2 (23.5 %), and Haemophilus influenzae (22.3 %). After excluding 50 cases with incomplete questionnaires, the analytical cohort consisted of 244 participants (83.0 % of total), 56.1 % of whom were female. The largest age group was 19-40 years (71.3 %), and 65 participants (26.6 %) had mixed infections. Higher symptom counts (adjusted OR=1.700, 95 % CI 1.346-2.147) and elevated NLR (adjusted OR=1.232, 95 % CI 1.068-1.422) were linked to mixed infections. SARS-CoV-2 co-infection was negatively associated with mixed infections (adjusted OR=0.141, 95 % CI 0.035-0.575).
CONCLUSIONS: Mixed infections correlate with greater symptom burden and higher inflammation markers. The inverse relationship with SARS-CoV-2 warrants further investigation. Findings support targeted pathogen testing in symptomatic patients with elevated NLR.