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Prevalence of respiratory pathogens and risk of developing pneumonia under non-pharmaceutical interventions in
1Pediatric Intensive Care Unit, Department of Infectious Diseases, Children's Hospital of Soochow University, Suzhou, China.
Insights
Non-pharmaceutical interventions (NPIs) impacted pathogen prevalence in hospitalized children with acute respiratory infections (ARIs). Human rhinovirus (HRV) became most common, while Mycoplasma pneumoniae (MP) posed the highest pneumonia risk.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Virology
- Epidemiology
Background:
- Acute Respiratory Infections (ARIs) are a significant cause of childhood hospitalization.
- Understanding pathogen prevalence and risk factors for complications like pneumonia is crucial for public health.
- The impact of non-pharmaceutical interventions (NPIs) on pediatric respiratory pathogen dynamics requires investigation.
Purpose of the Study:
- To evaluate the effect of NPIs on the prevalence of various respiratory pathogens in hospitalized children with ARIs.
- To identify the most common respiratory pathogens and their seasonal and age-specific distribution.
- To determine risk factors associated with the progression of respiratory infections to pneumonia.
Main Methods:
- Retrospective analysis of 10,396 children under 16 hospitalized with ARIs between September 2021 and December 2022.
- Multiplex PCR assays were used to detect 13 different respiratory pathogens.
- Demographic data, pathogen test results, and diagnostic information were collected and analyzed.
Main Results:
- Human rhinovirus (HRV) was the most prevalent pathogen (23.3%) following NPI implementation.
- Other common pathogens included human respiratory syncytial virus (HRSV, 15.9%) and human metapneumovirus (HMPV, 10.5%).
- Mycoplasma pneumoniae (MP), HMPV, Bocavirus, and HRSV were significantly associated with developing pneumonia.
Conclusions:
- NPIs altered the landscape of respiratory pathogens in hospitalized children, with HRV becoming dominant.
- Mycoplasma pneumoniae (MP) demonstrated the highest risk of progression to pneumonia among the studied pathogens.
- Age and seasonality play distinct roles in the prevalence of specific respiratory viruses and bacteria.
Abstract:
This study aims to evaluate the impact of non-pharmaceutical interventions (NPIs) on the prevalence of respiratory pathogens among hospitalised children with acute respiratory infections (ARIs) in Suzhou. Children with ARIs admitted to the Children's Hospital of Soochow University between 1 September 2021 and 31 December 2022 and subjected to 13 respiratory pathogen multiplex PCR assays were included in the study. We retrospectively collected demographic details, results of respiratory pathogen panel tests, and discharge diagnostic information of the participants, and described the age and seasonal distribution of respiratory pathogens and risk factors for developing pneumonia. A total of 10,396 children <16 years of age, including 5,905 males and 4,491 females, were part of the study. The positive rates of the 11 respiratory pathogen assays were 23.3% (human rhinovirus (HRV)), 15.9% (human respiratory syncytial virus (HRSV)), 10.5% (human metapneumovirus (HMPV)), 10.3% (human parainfluenza virus (HPIV)), 8.6% (mycoplasma pneumoniae (MP)), 5.8% (Boca), 3.5% (influenza A (InfA)), 2.9% (influenza B (InfB)), 2.7% (human coronavirus (HCOV)), 2.0% (adenovirus (ADV)), and 0.5% (Ch), respectively. Bocavirus and HPIV detection peaked during the period from September to November (autumn), and MP and HMPV peaked in the months of November and December. The peak of InfA detection was found to be in summer (July and August), whereas the InfB peak was observed to be in winter (December, January, and February). HRSV and HRV predominated in the <3 years age group. HRV and HMPV were common in the 3-6 years group, whereas MP was predominant in the ≥6 years group. MP (odds ratio (OR): 70.068, 95%CI: 32.665-150.298, P < 0.01), HMPV (OR: 6.493, 95%CI: 4.802-8.780, P < 0.01), Boca (OR: 3.300, 95%CI: 2.186-4.980, P < 0.01), and HRSV (OR: 2.649, 95%CI: 2.089-3.358, P < 0.01) infections were more likely to develop into pneumonia than the other pathogens. With the use of NPIs, HRV was the most common pathogen in children with ARIs, and MP was more likely to progress to pneumonia than other pathogens.
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