Cao Wenhan, Huang Huimin, Chang Zhenglin, Liang Zhiman, Fang Yanting, Li Lixian, Li Haiyang, Guo Yu, Chen Yuqi, Zhou Chengtao, Chen Zixin, Cheng Zhangkai J, Sun Baoqing
Department of Clinical Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
Guangzhou Medical University, Guangzhou, China.
J Thorac Dis. 2025 Mar 31;17(3):1452-1468. doi: 10.21037/jtd-24-1528. Epub 2025 Mar 18.
Respiratory pathogens pose significant public health challenges globally, particularly in densely populated urban areas. This study aimed to analyze the epidemiological trends of multiple respiratory pathogens in Guangzhou, China, from 2013 to 2023, and investigate associated serological profiles to inform clinical management and public health interventions.
We conducted a retrospective analysis of 96,927 cases with suspected respiratory infections (SRIs) (defined by fever >37.5 ℃, cough, dyspnea, and/or chest pain) at The First Affiliated Hospital of Guangzhou Medical University. Clinical data were extracted from electronic medical records, and immunofluorescence assays were used to detect immunoglobulin M (IgM) antibodies against nine respiratory pathogens.
Of the cases analyzed, 18.01% (17,454/96,927) tested serologically positive for at least one respiratory pathogen. (MP) was the predominant pathogen (76.51% of serologically positive cases), followed by parainfluenza viruses (PIVS) (9.75%). The highest serologically positive rate was observed in the 5-14 age group (36.01%). Females exhibited a significantly higher overall serologically positive rate (21.30%) compared to males (15.97%, P<0.001). Serological analysis revealed profiles in confirmed infections, with significantly lower coagulation-related parameters (P<0.001) and some elevated inflammatory markers compared to suspected cases.
This comprehensive study provides crucial insights into the changing landscape of respiratory pathogen infections in Guangzhou over an 11-year period. The predominance of MP, particularly among school-age children and females, highlights the need for targeted interventions. The unexpected coagulation profiles in confirmed infections suggest complex pathophysiological mechanisms that warrant further investigation. These findings have important implications for clinical management, diagnostic approaches, and public health strategies in urban settings.
呼吸道病原体在全球范围内构成重大公共卫生挑战，尤其是在人口密集的城市地区。本研究旨在分析2013年至2023年中国广州多种呼吸道病原体的流行病学趋势，并调查相关血清学特征，以为临床管理和公共卫生干预提供依据。
我们对广州医科大学附属第一医院96927例疑似呼吸道感染（SRI）病例（定义为发热>37.5℃、咳嗽、呼吸困难和/或胸痛）进行了回顾性分析。从电子病历中提取临床数据，并采用免疫荧光法检测针对9种呼吸道病原体的免疫球蛋白M（IgM）抗体。
在分析的病例中，18.01%（17454/96927）至少对一种呼吸道病原体血清学检测呈阳性。肺炎支原体（MP）是主要病原体（血清学阳性病例的76.51%），其次是副流感病毒（PIVS）（9.75%）。血清学阳性率最高的是5至14岁年龄组（36.01%）。女性的总体血清学阳性率（21.30%）显著高于男性（15.97%，P<0.001）。血清学分析揭示了确诊感染的特征，与疑似病例相比，凝血相关参数显著降低（P<0.001），一些炎症标志物升高。
这项综合研究为广州11年间呼吸道病原体感染情况的变化提供了关键见解。MP的优势地位，尤其是在学龄儿童和女性中，凸显了针对性干预的必要性。确诊感染中意外的凝血特征表明存在复杂的病理生理机制，值得进一步研究。这些发现对城市环境中的临床管理、诊断方法和公共卫生策略具有重要意义。
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