Longitudinal surveillance of respiratory pathogens among acute respiratory infection patients in Changshu, Jiangsu, China, 2021-2024.

Authors

Wenyan Tian, Zhengyuan Zhou, Jin Cao, Yuqin Zhang, Lijiao Cao, Haijun Du, Guoyong Mei, Zhiqiang Xia, Qinqin Song, Chun Xie, Jun Han

Published in

Journal of infection and public health. Volume 19. Issue 9. Pages 103325. Jul 24, 2026. Epub Jul 24, 2026.

Abstract

Acute respiratory infections (ARIs) remain a major global public health burden. This study aimed to characterize the longitudinal epidemiology, pathogen spectrum, and temporal patterns among ARI patients in Changshu, Jiangsu, China, from September 2021 to December 2024, encompassing the late COVID-19 pandemic and the subsequent post‑control era.
Nasopharyngeal swabs were collected from 4340 ARI patients attending eight sentinel hospitals. Seventeen respiratory pathogens were detected using real-time quantitative PCR. Demographic characteristics, clinical setting, age group, seasonality, monthly trends, and co-infection patterns were analyzed.
Overall, 1309 of 4340 patients (30.16%) tested positive for at least one pathogen. Influenza virus was the most frequently detected pathogen (9.61% of all specimens), followed by human adenovirus (HAdV) (4.82%) and human coronavirus (HCoV) (4.15%). The detection rate varied significantly by age, with the highest rate in children aged 5-17 years (46.28%). The pathogen detection rates in autumn (32.90%) and winter (32.89%) were higher than those in spring (26.11%) and summer (27.93%). Co-infections were identified in 199 patients (15.20% of positive cases), predominantly influenza-coronavirus combinations. Temporal analysis revealed a marked influenza‑associated increase in March 2023, a sustained increase in Mycoplasma pneumoniae detections from November 2023 onward, and a multi‑pathogen co‑circulation (including coronavirus, rhinovirus, adenovirus, influenza, and parainfluenza) after April 2024.
This longitudinal surveillance documented temporal changes in respiratory pathogen circulation in Changshu, including an influenza resurgence in early 2023, rising M. pneumoniae activity in late 2023, and concurrent increases in multiple viruses during 2024. These findings highlight the value of sustained county‑level monitoring to detect emerging epidemiological changes and inform local public health responses.

PMID:
42508258
Bibliographic data and abstract were imported from PubMed on 28 Jul 2026.

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