Analysis of changes in respiratory tract infections in a tertiary grade A hospital in Zhangjiakou area from 2018 to 2024.

We aimed to analyze the epidemiological characteristics and pathogen trends of common respiratory infections in a tertiary hospital in Zhangjiakou from 2018 to 2024. We retrospectively studied patients who underwent screening for 11 common respiratory pathogen antibodies at the First Affiliated Hospital of Hebei North University between January 1, 2018, and December 31, 2024. Serum-specific Immunoglobulin M antibodies were detected using indirect immunofluorescence assays, and annual data from 2018 to 2024 were compared. Among 35,665 patients, 10,531 (29.53%) were positive for at least 2 pathogen. The lowest positivity rate was observed in 2020 (23.47%, 841/3584), while the highest was observed in 2023 (38.58%, 3165/8204). Mycoplasma pneumoniae exhibited the highest positivity rate (11.99%, 4278/35,665), followed by influenza B virus (10.83%, 3861/35,665). Influenza A virus, respiratory syncytial virus, parainfluenza virus, Chlamydia pneumoniae, Legionella pneumophila, Coxsackie A virus, Coxsackie B virus, Echovirus, and adenovirus had relatively low positivity rates, ranging from 0.88% to 4.97%. Positive cases were stratified as follows: 0 to <3 years (13.32%, 1403/10,531), 3 to <6 years (17.52%, 1845/10,531), 6 to <12 years (18.35%, 1932/10,531), 12 to <18 years (6.37%, 671/10,531), 18 to <60 years (15.86%, 1670/10,531), and ≥60 years (28.58%, 3010/10,531). The proportion of patients <12 years significantly decreased by 2024 compared to 2018 (P < .001), while the proportion of patients significantly increased in the ≥60 group (P < .001). Single-pathogen infection was the predominant type (68.73%, 7238/10,531), followed by dual-pathogen infections (23.26%, 2450/10,531). The proportion of single-pathogen cases decreased from 75.59% in 2018 to 60.32% in 2023, rebounding to 74.36% in 2024. On the contrary, the number of dual-pathogen cases increased from 18.46% in 2018 to 27.65% in 2023, and then decreased to 21.67% in 2024 (P < .001). From 2018 to 2024, the epidemiological features of common respiratory pathogens exhibited significant temporal variations, with reduced positivity rates during the Coronavirus Disease 2019 pandemic and a sharp resurgence after the pandemic. Routine pathogen screening provides critical data for regional respiratory infection prevention and control.