Li Yuqing, Wei Mingwei, Cui Lunbiao, Huo Xiang, Ma Lisha, Tao Ran, Wu Tao, Qi Suyang, Wang Baolong, Shi Xiuyun, Liu Yuanbao, Liu Wenqing, Ge Yiyue, Chen Li, Zhao Xiujuan, Wu Jingjing, Qi Runjie, Zhu Fengcai, Li Jingxin
School of Public Health, National Vaccine Innovation Platform, Nanjing Medical University, Nanjing, China.
Jiangsu Provincial Medical Innovation Center, National Health Commission Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention (Jiangsu Provincial Academy of Preventive Medicine), Nanjing, China.
Front Public Health. 2025 Aug 4;13:1548190. doi: 10.3389/fpubh.2025.1548190. eCollection 2025.
Infants are vulnerable to acute respiratory infections (ARIs), which result in pediatric morbidity and even fatalities. A surge of ARIs among infants and young children was reported in China in 2023, garnering global attention. We aimed to investigate the frequency and types of respiratory pathogens associated with the risk of acute respiratory illnesses in infants and young children during this period.
We established a cohort of 2-month-old healthy infants across three counties in Suqian City, Jiangsu Province, China. The infants in the cohort donated throat swabs at enrollment and then underwent a follow-up for active monitoring of common ARIs. Throat swabs collected from infants experiencing common ARIs were analyzed for respiratory pathogens using targeted next-generation sequencing (tNGS).
Between 7 February and 17 April 2023, a total of 804 infants were invited to participate. Among them, 796 participants were enrolled (423 [53.1%] male, 373 [46.9%] female) with a median age of 71.0 days. Frequently detected respiratory pathogen carriers at baseline included () (17.9%), Cytomegalovirus (CMV) (16.0%), and (15.3%). In the follow-up period up to 30 April 2024, 1,412 episodes of common ARIs were recorded (164.5 per 100 person-years). A total of 675 specimens were collected during the episodes of common ARIs and qualified for analysis, of which 636 (94.2%) had at least one positive detection of respiratory pathogens, with the most frequently detected pathogens being CMV (43.7%), (35.6%), and Rhinovirus (HRV) (29.3%). Among the pathogens, human adenovirus (HAdV) and human respiratory syncytial virus (RSV) (18, 36.0%) were the most common pathogens detected among 50 hospitalized cases of ARIs.
Our data provide a better understanding of epidemiological patterns of respiratory pathogens in infants and young children from 2023 to 2024. CMV, and HRV were the most commonly detected pathogens in common ARI cases, while HAdV and RSV were more frequently observed in hospitalized cases with ARIs. These findings suggest that shifts in the pathogen spectrum are closely linked to disease severity, highlighting the need for targeted prevention and control strategies.
婴儿易患急性呼吸道感染（ARI），这会导致儿童发病甚至死亡。2023年中国报告了婴幼儿中ARI的激增，引起了全球关注。我们旨在调查这一时期与婴幼儿急性呼吸道疾病风险相关的呼吸道病原体的频率和类型。
我们在中国江苏省宿迁市的三个县建立了一个由2个月大的健康婴儿组成的队列。队列中的婴儿在入组时捐献咽拭子，然后进行随访以积极监测常见的ARI。对患有常见ARI的婴儿采集的咽拭子使用靶向二代测序（tNGS）分析呼吸道病原体。
在2023年2月7日至4月17日期间，共邀请了804名婴儿参与。其中，796名参与者入组（男性423名[53.1%]，女性373名[46.9%]），中位年龄为71.0天。基线时频繁检测到的呼吸道病原体携带者包括（此处原文缺失具体病原体名称）（17.9%）、巨细胞病毒（CMV）（16.0%）和（此处原文缺失具体病原体名称）（15.3%）。在截至2024年4月30日的随访期内，记录了1412例常见ARI发作（每100人年164.5例）。在常见ARI发作期间共采集了675份标本并符合分析条件，其中636份（94.2%）至少有一次呼吸道病原体阳性检测，最常检测到的病原体是CMV（43.7%）、（此处原文缺失具体病原体名称）（35.6%）和鼻病毒（HRV）（29.3%）。在这些病原体中，人腺病毒（HAdV）和人呼吸道合胞病毒（RSV）（18例，占36.0%）是50例ARI住院病例中最常见的病原体。
我们的数据有助于更好地了解2023年至2024年婴幼儿呼吸道病原体的流行病学模式。CMV、（此处原文缺失具体病原体名称）和HRV是常见ARI病例中最常检测到的病原体，而HAdV和RSV在ARI住院病例中更频繁地观察到。这些发现表明病原体谱的变化与疾病严重程度密切相关，突出了针对性预防和控制策略的必要性。
