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Pathogenic Agents Causing Acute Respiratory Tract Infections in Beijing During Autumn and Winter of 2023 to 2024：A Study of 5,556 Patients from Peking Union Medical College Hospital
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摘要: 目的 分析北京地区秋冬季急性呼吸道感染的流行特征，为急性呼吸道感染疾病的防控和诊治提供依据。方法 采用便利抽样法，以北京协和医院2023年9月—2024年2月因急性呼吸道感染就诊的患者为研究对象。采集患者鼻咽拭子标本，采用荧光定量PCR法检测6种常见呼吸道病原体[包括甲型流感病毒（ influenza A virus，FluA）、乙型流感病毒（ influenza B virus，FluB ）、鼻病毒（ human rhinovirus ，HRV ）、肺炎支原体（ mycoplasmapneumoniae，MP）、呼吸道合胞病毒（ respiratory syncytial virus，RSV）和腺病毒（ adenovirus，ADV）]和新型冠状病毒感染情况，对病原体感染分布特征进行分析。结果 共入选符合纳入标准的患者5556例，6种常见呼吸道病原体总体阳性率为63.7%，单一病原体阳性率为54.0%，2种病原体阳性率为8.9%，3种及以上病原体阳性率为0.7%。整体检出病原体以FluA和RSV为主，阳性率依次为16.1%和15.7%； ADV、MP、HRV和FluB阳性率接近，分别为11.1%、11.1%、10.0%和10.0%。病原体总体阳性率在性别间无显著性差异，但在秋冬季节间（χ2=34.617,P<0.001 ）以及儿童、中青年和老年患者间（χ2=422.38,P<0.001）存在统计学差异。其中，MP（χ2=8.647,P=0.003）、FluA（χ2=131.932,P<0.001）和HRV（χ2=174.199,P<0.001）在秋季的阳性率显著高于冬季，而FluB在冬季的阳性率显著高于秋季（χ2=287.894,P<0.001）；儿童组MP、RSV、HRV和ADV的阳性率均显著高于中青年和老年患者（P均<0.001），而FluB在中青年患者中的阳性率则显著高于儿童和老年患者（P均<0.001）。6种常见呼吸道病原体在新型冠状病毒感染流行时期阳性率明显下降，表现为非同步季节性模式。结论 北京地区呼吸道病原体流行情况与年龄、季节有关，需在不同季节、针对不同重点人群开展有针对性的预防措施。Abstract: Objective To investigate the pathogen spectrum of acute respiratory infections in Beijing during autumn and winter of 2023 to 2024. The findings will provide valuable insights for clinical diagnosis, treatment, prevention and control of respiratory infectious diseases through epidemiological analysis. Methods This study focused on patients who visited Peking Union Medical College Hospital for acute respiratory infections from September 2023 to February 2024 by convenience sampling.We used fluorescence quantitative PCR to detect six respiratory pathogens, namely influenza A virus (FluA), influenza B virus (FluB), Human rhinovirus (HRV), Mycoplasma pneumoniae (MP), respiratory syncytial virus (RSV), and adenovirus (ADV), in 5556 respiratory tract samples collected from patients with respiratory tract infections. Additionally, we analyzed the distribution of pathogen infections by combining the results with COVID-19 infections during the same period. Results Among the 5556 samples, the overall positive rate was 63.7%. The positive rates for single pathogen infections, dual pathogen infections, and infections with three or more pathogens were 54.0%, 8.9%, and 0.7% respectively. In terms of overall detection of pathogens, FluA and RSV were the predominant pathogens, with positive rates of 16.1% and 15.7% respectively. The positive rates for ADV, MP, HRV, and FluB were similar, at 11.1%, 11.1%, 10.0%, and 10.0% respectively. Although there was no difference in the overall pathogen positive rate between different genders and seasons, statistical differences were witnessed in the infection rates and pathogen compositions among different age groups (χ2=34.617, P<0.001, χ2=422.38, P<0.001). There were variations in the detection rates of MP, FluA, FluB, and HRV between different seasons (P<0.005). The positive rates of MP（χ2=8.647, P=0.003）、 FluA （χ2=131.932, P<0.001）和 HRV（χ2=174.199, P<0.001） were significantly higher in autumn than in winter, while FluB showed the opposite trend （χ2=287.894, P<0.001）, predominantly occurring in winter. The positive rates of MP, RSV, HRV, and ADV in the pediatric group were significantly higher than those in the middleaged and elderly patients (all P <0.001), while the positive rate of FluB in middleaged patients was significantly higher than that in both children and elderly patients (P <0.001 for both). The overall number of cases infected with the six respiratory pathogens decreased significantly during the period of COVID-19 infection, exhibiting an asynchronous seasonal pattern. Conclusion The detection rate of respiratory pathogens in Beijing was related to age and season. Targeted prevention and control measures should be implemented for different populations in different seasons, and early epidemic warnings should be issued.
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Keywords:
- acute respiratory infections /
- pathogens /
- COVID-19 /
- Beijing /
- epidemiological characteristics
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