Analysis of influenza A, influenza B and Mycoplasma pneumoniae infection in children hospitalized with acute respiratory tract infection in Xi’an from 2021 to 2023

TL;DR

This study analyzed the presence of three pathogens in children hospitalized with respiratory infections in Xi’an from 2021 to 2023, finding significant changes in infection rates over time.

Contribution

The study provides updated epidemiological data on FluA, FluB, and Mp infections in children with ARTI in Xi’an over a three-year period.

Findings

Mycoplasma pneumoniae was the most frequently detected pathogen, with a detection rate of 30.14%.

FluA detection increased significantly from 0.53% in 2021 to 12.90% in 2023.

Co-infection rates rose from 0.75% in 2021 to 2.38% in 2023.

Abstract

To evaluate the occurrence of three pathogens, influenza virus A (FluA), influenza virus B (FluB) and Mycoplasma pneumoniae (Mp) in children hospitalized with acute respiratory tract infection (ARTI) between 2021 and 2023.

FluA, FluB and Mp were detected by antigen/antibody kit in specimens from 29,014 children with ARTI admitted to Xi’an Children’s Hospital.

The total pathogen detection rate was 43.79% (12,707/29014) with 30.14% (8,745/29014) Mp-positive cases, 7.08% (55/29014) FluA-positive and 6.57% (1907/29014) FluB-positive. Total detection rates were 28.05% (2,472/8813) in 2021, 29.38% (2,550/8680) in 2022 and 66.70% (7,685/11521) in 2023. Co-infection rates with two or more pathogens increased over the period of interest from 0.75% (66/8813) in 2021, 0.93% (81/8680) in 2022 to 2.38% (274/11521) in 2023 (χ2 = 115.931, p < 0.001). FluA detection also increased and was present in 0.53% cases in 2021, 6.01% in 2022 and 12.90% in 2023, reaching a peak in February 2023 of 17.83% and March 2023 of 64.42%. FluB detection rates were more stable at 5.25% in 2021, 7.67% in 2022 and 6.75% in 2023, reaching a peak of 22.17% in December 2023. Mp detection was higher in 2023 at 47.05% with a peak of 82.21% in October 2023 than in 2021 (15.89%) or 2022 (15.69%). More FluA-positive cases were seen in the >12 age groups than in younger children and FluB detection also increased with age. Mp infection was detected in the >4 age group.

The pathogen spectrum and epidemiology of ARTI changed between 2021 and 2023. Age-specific bandings of infection were seen in the cohort of children. Outbreaks of FluA, FluB and Mp influence the pathology of ARTI.