新冠肺炎大流行前后中南地区呼吸道病原体流行情况分析
Analysis of the epidemic situation of respiratory pathogens in central and southern China before and after the COVID-19 pandemic.
摘要(中文译文)
呼吸道感染是导致儿科住院的常见疾病，其流行病学趋势随季节和年龄呈现不同特征。本研究回顾性分析了2018年至2023年12种呼吸道病原体的感染状况，并考察了COVID-19疫情前后的变化。研究纳入2018年至2023年在长沙某三级医院接受多重PCR检测的51,597例疑似呼吸道感染的住院儿童。检测项目包括呼吸道合胞病毒、腺病毒、流感病毒、副流感病毒、肺炎支原体、肺炎衣原体及细菌培养结果等。婴儿组阳性率最高，为39.25%（7,729/19,693），学龄组最低，为25.34%（2,015/7,951）（< 0.05）。2020—2021年期间，病原体阳性率较疫情前水平下降；2022年末出现甲型流感（FluA）、乙型流感（FluB）及副流感病毒1—3型（PIV1-3）的高峰。2023年限制措施解除后，甲型流感、乙型流感、副流感病毒1型（PIV1）、副流感病毒3型（PIV3）、腺病毒（AdV）和呼吸道合胞病毒（RSV）均出现回升。在细菌病原体中，肺炎链球菌占26.35%（2,104/7,983），其次为流感嗜血杆菌（20.11%）和卡他莫拉菌（14.93%）（< 0.005）。共感染分析显示，大肠埃希菌、肺炎克雷伯菌和鲍曼不动杆菌之间存在显著的正向交互作用，铜绿假单胞菌与鲍曼不动杆菌/肺炎克雷伯菌之间亦存在显著正向交互作用（>0.9，< 0.05）。肺炎支原体更易与病毒性病原体共感染，而非细菌性病原体。受疫情影响，呼吸道病原体的阳性率和疾病谱发生了变化。疫情导致了最初的抑制，限制措施解除后呼吸道合胞病毒、流感病毒和肺炎支原体出现明显回升。分段回归分析证实，呼吸道合胞病毒在疫情后反弹最为陡峭，且封锁期间出生的幼儿感染激增尤为显著，支持“免疫债务”假说。这些发现强调了针对年龄的特异性监测对预防儿科危重症的重要性。
Abstract
Respiratory tract infection is a common disease leading to pediatric hospitalization, exhibiting different epidemiological trends with seasons and ages. This study retrospectively analyzed the infection status of 12 respiratory pathogens from 2018 to 2023, and examined the changes before and after the COVID-19 pandemic. A total of 51,597 hospitalized children with suspected respiratory tract infection, who underwent multiplex PCR testing in a tertiary hospital in Changsha from 2018 to 2023 were included. Testing items included respiratory syncytial virus, adenovirus, influenza virus, parainfluenza virus, Mycoplasma pneumoniae, Chlamydia pneumoniae, and bacterial culture results, among others. The infant group had the highest positive rate at 39.25% (7,729/19,693), and the school-age group the lowest at 25.34% (2,015/7,951) ( < 0.05). During 2020-2021, pathogen positive rates declined compared with pre-pandemic levels; a peak of FluA, FluB, and PIV1-3 occurred in late 2022. After restriction lifting in 2023, FluA, FluB, PIV1, PIV3, AdV, and RSV all rebounded. Among bacterial pathogens, Streptococcus pneumoniae accounted for 26.35% (2,104/7,983), followed by Haemophilus influenzae (20.11%) and Moraxella catarrhalis (14.93%) ( < 0.005). Co-infection analysis revealed significant positive interactions among Escherichia coli, Klebsiella pneumoniae, and Acinetobacter baumannii, and between Pseudomonas aeruginosa and A. baumannii/K. pneumoniae (>0.9, < 0.05). M. pneumoniae was more likely to co-infect with viral than bacterial pathogens. Due to the impact of the epidemic, the positive rate and disease spectrum of respiratory pathogens have changed. The pandemic induced an initial suppression followed by a marked resurgence of RSV, influenza, and M. pneumoniae after restrictions were lifted. Segmented regression confirmed RSV exhibited the steepest post-pandemic rebound, and toddlers born during lockdown showed a disproportionate surge in infections, supporting the "immunity debt" hypothesis. These findings underscore the importance of age-specific surveillance for preventing pediatric critical illness.
如何引用
AMA
Zhuoya Xiao, Linfei Yang, Ting Shi, Yuqi She, Zhimin Wan, Yufang Hu, et al. Analysis of the epidemic situation of respiratory pathogens in central and southern China before and after the COVID-19 pandemic.. Frontiers in pediatrics. 2026; doi:10.3389/fped.2026.1826861.
APA
Zhuoya Xiao, Linfei Yang, Ting Shi, Yuqi She, Zhimin Wan, Yufang Hu, et al (2026). Analysis of the epidemic situation of respiratory pathogens in central and southern China before and after the COVID-19 pandemic.. Frontiers in pediatrics. https://doi.org/10.3389/fped.2026.1826861
GB/T 7714
Zhuoya Xiao, Linfei Yang, Ting Shi, Yuqi She, Zhimin Wan, Yufang Hu, et al. Analysis of the epidemic situation of respiratory pathogens in central and southern China before and after the COVID-19 pandemic.[J]. Frontiers in pediatrics, 2026 doi:10.3389/fped.2026.1826861.
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