New Epidemiological and Clinical Signatures of 18 Pathogens from Respiratory Tract Infections Based on a 5-Year Study

Abstract

BackgroundRespiratory tract infections (RTIs) are a heavy burden on society. However, due to the complex etiology of RTIs, the clinical diagnosis, treatment, and prevention of these infections remain challenging, especially in developing countries.MethodsTo determine the epidemiological and clinical characteristics of 18 respiratory pathogens, we analyzed 12,502 patients with acute respiratory infections (ARIs) by performing polymerase chain reaction (PCR) on patient pharyngeal swabs.ResultsSamples positive for at least 1 pathogen were obtained from 48.42% of the total patients. Of these pathogen-positive patients, 17.99% were infected with more than 1 pathogen. Of the 18 pathogens analyzed, four were detected with a positive detection rate (PDR) > 5%: influenza A virus (IAV) > respiratory syncytial virus (RSV) >Mycoplasma pneumoniae (MP) > human coronavirus (HCoV). The pathogens with the 4 highest co-infection rates (CIRs) were as follows: HCoV > human bocavirus (HBoV) > enterovirus (EV) > parainfluenza virus (PIV). The overall positive detection rate (PDR) varied significantly according to patient age, the season and year of detection, and the disease subgroup, but not according to patient sex. The individual PDRs of the pathogens followed 3 types of distributions for patient sex, 4 types of distributions for patient age, 4 types of seasonal distributions, 2 types of seasonal epidemic trends, 4 types of yearly epidemic trends, and different susceptibility distributions in the disease subgroups. Additionally, the overall CIR showed significantly different distributions according to patient sex, patient age, and the disease subgroup, whereas the CIRs of individual pathogens suggested significant preference characteristics.ConclusionIAV remains the most common pathogen among the pathogens analyzed. More effort should be directed toward the prevention and control of pathogens that show a trend of increasing incidence such as HCoV, human adenovirus (ADV), and RSV. Although clinically distinguishing specific pathogens responsible for RTIs is difficult, the epidemiological and clinical characteristics of the various RTI-causing agents could provide clues for clinicians, thereby informing decisions regarding prevention and medication and guiding appropriate public health strategies.

Epidemiology of Respiratory Pathogens in Children with Lower Respiratory Tract Infections in Shanghai, China, from 2013 to 2015

“…The detection of MP, PIV, and hMPV was the highest in autumn, summer, and spring, respectively. These results are similar to the findings in Guangzhou, China (14). Nevertheless, a multicenter study conducted in the United States revealed that MP peaked in the winter, and a study conducted in Shenzhen, China, indicated that the detection rate of PIV was highest in autumn (10,15).…”

Clinical characteristics and viral etiologies of outpatients with acute respiratory infections in Huzhou of China: a retrospective study

“…Moreover, our results demonstrated that EV infections occurred between April and September 2015, with the peak detection rate in August 2015, which was in accordance with previous reports [27]. Many studies have shown that EVs are often detected in summer and autumn [27,[31][32][33][34]. We speculate that climate conditions might be an important factor for EV detection in temperate regions.…”

Etiology of Coinfections in Children with Influenza during 2015/16 Winter Season in Nepal

“…Details of pathogens in single and multiple respiratory infections with influenza-positive cases.Similar findings of single and multiple pathogen coinfections with influenza have been reported from Brazil, Turkey, Japan, and China[29][30][31][32][33][34].To the best of our knowledge, this could be the first study undertaken with multiplex RT-PCR kit on 21 respiratory pathogen for detection of influenza A, A/H1N1, influenza B, RV, RSV A-B, PIV 1-4, coronavirus OC43, NL63, 229E, and HKU1, MPV A-B, BV, Mycoplasma pneumoniae, AV, EV, and PeV. Recently, Rutvisuttinunt et al have reported the detection rate of viral pathogens (71.3%) in specimens of ARI cases collected from South East Asian countries including Nepal.…”