Epidemiological characteristics of six respiratory pathogens in respiratory infections in Fuzhou, China.

OBJECTIVE: To characterize the burden and features of respiratory pathogens infections among patients with Acute Respiratory Tract Infections (ARTIs) in Fuzhou, China. Providing evidence-based guidance for outbreak prevention. METHODS: From December 2023 to February 2025, 10,355 ARTI patients at Fuzhou University Affiliated Provincial Hospital were tested for six pathogens (Influenza A virus (FLUA), Influenza B virus (FLUB), respiratory syncytial virus (RSV), Human rhinovirus (HRV), adenovirus (ADV), and Mycoplasma pneumoniae (MP)) using multiplex PCR. Detection rates and epidemiological characteristics were analyzed. RESULTS: Among enrolled patients, 4,699 (45.37%) tested positive. Overall pathogen detection showed no significant gender difference. However, RSV positivity was higher in males (P =0.046), while MP infection predominated in females (P <0.0001). MP predominated among single infections (14.72%), followed by HRV (13.54%), ADV (9.13%), FLUA (8.93%), RSV (3.43%), and FLUB (2.57%). Major coinfections (>1%) included HRV+MP (2.98%), ADV+MP (2.87%), HRV+FLUA (2.06%), and ADV+HRV (1.64%). These pathogens constituted the primary etiology of pediatric ARTIs. Distinct seasonal patterns emerged: FLUA peaked in spring/winter; FLUB and MP surged in winter; RSV circulated in spring/autumn; ADV prevailed in autumn/winter; HRV was endemic in summer/autumn/winter. HRV positivity correlated inversely with improved air quality (daily index <60). RSV outbreaks exhibited a lagged correlation with precipitation and demonstrated a "compensatory peak" relative to FLUA. Compared to individuals >60 years（y）: Children <7 y had significantly elevated RSV risk; Minors <18 y showed reduced FLUA susceptibility; FLUB risk increased in ages 1-60 y; Those <60 y exhibited higher ADV, HRV, and MP infection risks. Relative to winter: Spring decreased FLUA/B/MP risk but increased RSV/HRV; Summer lowered FLUB/MP risk while elevating RSV; Autumn reduced FLUA/B/ADV/MP risk but heightened RSV/HRV. Multivariate analysis identified age >60 y and RSV/HRV/MP infection as independent risk factors for lower respiratory tract involvement. CONCLUSION: The epidemiology of these six pathogens exhibits significant age-, season-, and climate-dependent variations, necessitating tailored preventive strategies. Enhanced vigilance for lower respiratory complications is warranted in individuals ≥60 y and those infected with RSV, HRV, or MP. These findings provide critical insights for targeted interventions.