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Drivers of respiratory infection landscapes in the post-pandemic era - The interplay of age, seasonality, and inter-annual variability in pathogen distribution: A retrospective surveillance study.

Created on 22 Jun 2026

Authors

Tianxi Yu, Shuang Feng, Chenguang Guo, Ziwei Lv, Yuan Li, Xiaoyan Li, Lei Yu

Published in

Public health. Volume 258. Pages 106379. Jun 20, 2026. Epub Jun 20, 2026.

Abstract

To evaluate pathogen spectrum and epidemiological dynamics of acute respiratory infections (ARI) in Nankai District, Tianjin, during the post-pandemic era (2024-2025).
Retrospective surveillance study.
A total of 1853 ARI specimens were retrospectively collected from two sentinel hospitals during weeks 1-52 of 2024-2025. Multiplex PCR was used to detect 31 pathogens. Statistical analyses were performed using SPSS 25.0.
The overall positivity rate was 39.61% (734/1853). Viral pathogens predominated (66.02%), followed by bacterial (23.53%) and atypical pathogens (10.45%). The top five pathogens were SARS-CoV-2 (8.90%), Haemophilus influenzae (6.31%), influenza A H3N2 (5.02%), Mycoplasma pneumoniae (4.75%), and influenza A H1N1 (3.99%). Males showed higher co-infection rates than females (P = 0.020). Positivity rates were highest in the 35-59 (48.19%) and 18-34 age groups (47.43%). M. pneumoniae primarily affected children aged 4-17 years, whereas SARS-CoV-2 was more prevalent in adults. Spring and winter exhibited the highest positivity rates, with summer the lowest (22.17%). Significant inter-annual differences were observed (P < 0.001). 2024 showed "immunity debt"-driven compensatory outbreaks with atypical pathogens, while 2025 returned to viral dominance (64.64%), particularly H3N2.
Post-pandemic ARI demonstrates pronounced de-dominance and multi-pathogen co-circulation, with notable age, seasonal, and inter-annual specificity. Continuous comprehensive surveillance is essential for optimizing clinical diagnostics and public health strategies.

PMID:
42322710
Bibliographic data and abstract were imported from PubMed on 22 Jun 2026.

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