ArticleBMC infectious diseases2025
Post-pandemic shifts in pediatric respiratory pathogens and co-infection dynamics in Xi'an and surrounding areas: a large-scale retrospective study from 2021 to 2025.
Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Epidemiological characterization and phylogenetic analysis of human metapneumovirus isolated from children in Ningbo, China, 2020-2024.Microbial genomics · 2026Article
- Generalized additive model integrating multi-source data for short-term influenza forecasting in Shenzhen, China (2023-2025).Frontiers in public health · 2026Article
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10 authors.
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Abstract
BACKGROUND AND
objectiveThe COVID-19 pandemic and subsequent changes in public health policies have profoundly altered respiratory pathogen circulation patterns. This study aimed to characterize pathogen distribution, temporal trends, and co-infection dynamics among pediatric patients with respiratory tract infection (RTI) across epidemic and post-epidemic periods in northwest China.
methodsWe retrospectively analyzed 37,678 hospitalized pediatric RTI cases at Xi’an Children’s Hospital from July 2021 to April 2025. Multiplex reverse transcription PCR with capillary electrophoresis was used to detect 13 common respiratory pathogens. We compared pathogen prevalence and co-infection rates between the epidemic (2021–2022) and post-epidemic (2023–2025) periods. Multivariate logistic regression and co-infection network visualization were used to identify risk factors and interaction patterns.
resultsAmong all cases, 60.6% tested positive for at least one pathogen, with human rhinovirus (HRV, 11.60%), Mycoplasma pneumoniae (Mp, 9.78%), and human respiratory syncytial virus (HRSV, 8.66%) most frequently detected. Post-epidemic periods saw significant increases in Mp and HRSV. Specifically, Mp increased from 4.35% to 11.21%, and HRSV from 5.01% to 9.62%. The proportion of co-infections increased from 4.05% to 11.55% (p < 0.001), with HRV and Mp being the predominant pathogens in co-infections. Co-infection risk was significantly higher in children aged 0–12 years and during the post-epidemic period. Co-infection peaks occurred consistently in late autumn.
conclusionThis large-scale study reveals a substantial post-pandemic resurgence of Mp, HRSV, and co-infections among children in northwest China. HRV played a central role in co-infection networks. The findings highlight the importance of enhancing surveillance, developing preparedness frameworks, and specifically addressing pediatric co-infection dynamics. CLINICAL TRIAL NUMBER: Not applicable.
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