Xu Mengyun, He Wenying, Xie Songsong, Ren Zhongye, Chen Jie, Nuerbolati Bahejianati
Shihezi University School of Medicine, Shihezi, Xinjiang, China.
First Affiliated Hospital of Shihezi University School of Medicine, Shihezi, Xinjiang, China.
APMIS. 2025 Jan;133(1):e13484. doi: 10.1111/apm.13484. Epub 2024 Oct 24.
This research comprehensively investigates the epidemiological features and pathogen profile of acute respiratory infections (ARI) in Shihezi City, Xinjiang. A pivotal aspect of this study is the construction of a Bayes discriminant function for principal pathogen infections. This innovative methodology aims to furnish a robust scientific basis for the prevention and clinical management of ARI, potentially guiding more effective strategies in both public health and clinical settings. We compiled and examined data from January 2020 to June 2023, pertaining to patients admitted with acute respiratory infections at the First Affiliated Hospital of Shihezi University. This investigation focused on discerning patterns in epidemiology and pathogen etiology. Among 2110 cases of acute respiratory infections (ARI), 1736 underwent pathogenetic testing. Of these, 595 cases tested positive for at least one pathogen, marking a positivity rate of 34.27%. Viral detections, at a rate of 27.47%, were notably higher than bacterial detections, which stood at 6.51%. The most prevalent viruses identified were Human respiratory syncytial virus (hRSV), Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and Human adenovirus (HAdV), while the dominant bacterial pathogens included Klebsiella pneumoniae, Haemophilus influenzae, and Staphylococcus aureus. Co-infections were observed in 76 cases, accounting for 12.77% of positive diagnoses, predominantly involving hRSV in conjunction with other pathogens. In cases of acute bronchiolitis, hRSV was the most frequent pathogen, contributing to 23.10% of such cases. Similarly, in severe pneumonia cases, SARS-CoV-2 was predominant, accounting for 25.4% of these infections. The group with bacterial positivity exhibited elevated levels of C-reactive protein (CRP, 19.17 mg/L) and neutrophilic granulocyte percentage (NE%, 54.7%). The Bayes discriminant function demonstrated an initial validation accuracy of 74.9% and a cross-validation accuracy of 63.7%. The study underscores that hRSV, SARS-CoV-2, and HAdV are the primary pathogens in acute respiratory infections in the Shihezi region. Pathogen susceptibility exhibits variation across different age groups, with a higher pathogen detection rate in children compared to adults. The Bayes discriminant function shows significant promise in the classification and diagnosis of major pathogenic infections.
本研究全面调查了新疆石河子市急性呼吸道感染（ARI）的流行病学特征和病原体谱。本研究的一个关键方面是构建主要病原体感染的贝叶斯判别函数。这种创新方法旨在为ARI的预防和临床管理提供坚实的科学依据，可能为公共卫生和临床环境中更有效的策略提供指导。我们收集并检查了2020年1月至2023年6月期间石河子大学第一附属医院收治的急性呼吸道感染患者的数据。这项调查的重点是识别流行病学和病原体病因学方面的模式。在2110例急性呼吸道感染（ARI）病例中，1736例进行了病原体检测。其中，595例至少检测出一种病原体呈阳性，阳性率为34.27%。病毒检测率为27.47%，明显高于细菌检测率，细菌检测率为6.51%。鉴定出的最常见病毒是人呼吸道合胞病毒（hRSV）、严重急性呼吸综合征冠状病毒2（SARS-CoV-2）和人腺病毒（HAdV），而主要的细菌病原体包括肺炎克雷伯菌、流感嗜血杆菌和金黄色葡萄球菌。共发现76例合并感染，占阳性诊断的12.77%，主要是hRSV与其他病原体合并感染。在急性细支气管炎病例中，hRSV是最常见的病原体，占此类病例的23.10%。同样，在重症肺炎病例中，SARS-CoV-2占主导地位，占这些感染的25.4%。细菌阳性组的C反应蛋白（CRP，19.17mg/L）和中性粒细胞百分比（NE%，54.7%）水平升高。贝叶斯判别函数的初始验证准确率为74.9%，交叉验证准确率为63.7%。该研究强调，hRSV、SARS-CoV-2和HAdV是石河子地区急性呼吸道感染的主要病原体。病原体易感性在不同年龄组中存在差异，儿童的病原体检测率高于成人。贝叶斯判别函数在主要致病感染的分类和诊断方面显示出巨大潜力。
