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Journal of Peking University (Health Sciences) ›› 2025, Vol. 57 ›› Issue (3): 496-506. doi: 10.19723/j.issn.1671-167X.2025.03.013

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Distribution of respiratory pathogens in patients with pneumonia in Yinzhou, Ningbo, 2015-2024

Ziming YANG1,2, Shuya LI1,2, Xiaotong LI1,2, Peng SHEN3, Yexiang SUN3, Hongbo LIN3, Zhiqin JIANG3, Siyan ZHAN1,2,4,5,*(), Zhike LIU1,2,*()   

  1. 1. Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
    2. Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
    3. Yinzhou District Center for Disease Control and Prevention of Ningbo, Ningbo 315199, Zhejiang, China
    4. Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China
    5. Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing 100871, China
  • Received:2025-01-29 Online:2025-06-18 Published:2025-06-13
  • Contact: Siyan ZHAN, Zhike LIU
  • Supported by:
    the National Natural Science Foundation of China(82330107); the National Natural Science Foundation of China(72361127500)

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Abstract:

Objective: To describe the epidemiological characteristics of 22 common respiratory pathogens in patients with pneumonia in Yinzhou, Ningbo, from January 1, 2015 to December 21, 2024. Methods: The test data of 22 common respiratory pathogens in patients diagnosed with pneumonia or lung infection in the Yinzhou Regional Health Information Platform from January 1, 2015 to December 21, 2024 were collected. The positive cases, positive rates, and positive proportions were calculated. The epidemiological characteristics were described by the year, sex, age group, season, and coronavirus disease 2019 (COVID-19) pandemic period. Results: A total of 77 531 pneumonia patients were included, with 492 696 respiratory pathogen tests performed. The number of respiratory pathogen tests and positive cases of pneumonia patients in Yinzhou showed an upward trend. In the study, 34.63% of the pneumonia patients tested positive for at least one pathogen, and the pathogen non-detection rate decreased from 79.44% in 2015 to 58.38% in 2024. The overall pathogen positive rate was 9.12%, which decreased during the COVID-19 pandemic and had not returned to the historical level after the COVID-19 pande- mic. The positive rate was highest in children aged 6-17 years (13.99%), and lowest in the elderly over 60 years (4.16%). The top 3 highest number of positive cases was Mycoplasma pneumoniae, influenza A virus, and influenza B virus; the top 3 highest positive rates of pathogen tests were Mycoplasma pneumoniae (25.26%), rhinovirus (12.02%), and Bordetella pertussis (11.66%). The pathogen spectrum proportion in men was similar to that in women, only showing a higher ratio of Mycobacterium tuberculosis and a slightly lower ratio of Mycoplasma pneumoniae (P < 0.001). Mycoplasma pneumoniae, respiratory syncytial virus, and rhinovirus infections were more common in children, while influenza virus, Mycobacterium tuberculosis, and Streptococcus pyogenes infections were more common in adults and the elderly (P < 0.001). Influenza virus and human metapneumovirus infections were more common in winter, rhinovirus and Bordetella pertussis infections were more common in spring, and Mycoplasma pneumoniae infections were relatively more common in fall (P < 0.001). After the COVID-19 pandemic, the proportions of rhinovirus, respiratory syncytial virus, and human metapneumovirus infections in the pneumonia patients increased signi-ficantly, reaching 7.53%, 4.26%, and 2.25%, respectively, while the proportions of influenza B virus and Mycobacterium tuberculosis infections decreased to 4.14% and 2.80%, respectively (P < 0.001). Conclusion: In the past decade, the scale of respiratory pathogen infection in the pneumonia population in Yinzhou had expanded significantly, and there were differences in distribution by the year, gender, age group, and season. The respiratory pathogen spectrum in pneumonia patients after the COVID-19 pandemic had a trend of diversification.

Key words: Pneumonia, Pathogens, Epidemiological characteristics, Public health surveillance

CLC Number: 

  • R184

Table 1

Basic characteristics of the subjects"

Characteristics Test person-time Positive person-time Positive rate/% (95%CI) P
Gender < 0.001
  Man 260 029 22 724 8.74 (8.63, 8.85)
  Woman 232 667 22 228 9.55 (9.43, 9.67)
Ethnicitya 0.556
  Han 369 705 34 236 9.26 (9.17, 9.35)
  Minorities 587 59 10.05 (7.74, 12.77)
Age group/years < 0.001
  0-5 169 798 17 027 10.03 (9.89, 10.17)
  6-17 121 281 16 970 13.99 (13.80, 14.19)
  18-44 46 609 3 958 8.49 (8.24, 8.75)
  45-59 39 278 2 187 5.57 (5.34, 5.80)
  ≥60 115 730 4 810 4.16 (4.04, 4.27)
Year < 0.001
  2015 1 075 108 10.05 (8.31, 12.00)
  2016 2 665 386 14.48 (13.17, 15.88)
  2017 10 196 1 213 11.90 (11.27, 12.54)
  2018 20 592 2 141 10.40 (9.98, 10.82)
  2019 42 968 5 220 12.15 (11.84, 12.46)
  2020 24 528 2 203 8.98 (8.63, 9.35)
  2021 36 231 2 477 6.84 (6.58, 7.10)
  2022 43 548 3 426 7.87 (7.62, 8.12)
  2023 140 618 13 422 9.55 (9.39, 9.70)
  2024 170 275 14 356 8.43 (8.30, 8.56)
Season < 0.001
  Spring 107 354 8 829 8.22 (8.06, 8.39)
  Summer 107 801 9 810 9.10 (8.93, 9.27)
  Fall 136 109 13 367 9.82 (9.66, 9.98)
  Winter 141 432 12 946 9.15 (9.00, 9.30)
COVID-19 period < 0.001
  Before 77 496 9 068 11.70 (11.48, 11.93)
  During 104 307 8 106 7.77 (7.61, 7.94)
  After 310 893 27 778 8.93 (8.83, 9.04)
Total 492 696 44 952 9.12 (9.04, 9.20)

Table 2

Person-time and positive rate of laboratory tests for each pathogen"

Pathogen Test person-time Positive person-time Positive rate/% (95%CI)
Influenza A virus 76 849 5 111 6.65 (6.48, 6.83)
Influenza B virus 44 721 2 745 6.14 (5.92, 6.36)
Parainfluenza virus 21 528 862 4.00 (3.75, 4.27)
Human adenovirus 39 065 1 119 2.86 (2.70, 3.03)
Human metapneumovirus 12 871 692 5.38 (4.99, 5.78)
Respiratory syncytial virus 36 461 1 605 4.40 (4.19, 4.62)
Human coronavirus 12 911 138 1.07 (0.90, 1.26)
Human rhinovirus 18 996 2 283 12.02 (11.56, 12.49)
Human bocavirus 12 921 166 1.28 (1.10, 1.49)
Streptococcus pneumoniae 331 8 2.42 (1.05, 4.71)
Streptococcus pyogenes 11 972 446 3.73 (3.39, 4.08)
Staphylococcus aureus 503 18 3.58 (2.13, 5.60)
Haemophilus influenzae 28 105 15 0.05 (0.03, 0.09)
Bordetella pertussis 1 570 183 11.66 (10.11, 13.35)
Escherichia coli 522 11 2.11 (1.06, 3.74)
Klebsiella pneumoniae 1 710 34 1.99 (1.38, 2.77)
Mycobacterium tuberculosis 23 226 1 995 8.59 (8.23, 8.96)
Pseudomonas aeruginosa 1 428 39 2.73 (1.95, 3.71)
Legionella pneumophila 6 157 57 0.93 (0.70, 1.20)
Mycoplasma pneumoniae 106 260 26 843 25.26 (25.00, 25.52)
Chlamydia 32 847 582 1.77 (1.63, 1.92)
Rickettsia 1 742 0 0.00 (0.00, 0.21)
Virus total 276 323 14 721 5.33 (5.24, 5.41)
Bacterium totala 75 524 2 806 3.72 (3.58, 3.85)

Figure 1

Gender and age distribution of respiratory pathogens A, proportion of gender by pathogens infection; B, proportion of pathogens infection by gender; C, proportion of age groups by pathogens infection; D, proportion of pathogens infection by age group. FluA, influenza A virus; FluB, influenza B virus; PIV, parainfluenza virus; HAdV, human adenovirus; HMPV, human metapneumovirus; RSV, respiratory syncytial virus; HCoV, human coronavirus; HRV, human rhinovirus; HBoV, human bocavirus; S. pneumoniae, Streptococcus pneumoniae; S. pyogenes, Streptococcus pyogenes; S. aureus, Staphylococcus aureus; H. influenzae, Haemophilus influenzae; B. pertussis, Bordetella pertussis; E. coli, Escherichia coli; K. pneumoniae, Klebsiella pneumoniae; M. tuberculosis, Mycobacterium tuberculosis; P. aeruginosa, Pseudomonas aeruginosa; L. pneumophila, Legionella pneumophila; M. pneumoniae, Mycoplasma pneumoniae."

Figure 2

Epidemiological characteristics and trends of respiratory pathogens from 2015 to 2024 A, person-time of positive infection; B, proportion of positive infection. FluA, influenza A virus; FluB, influenza B virus; PIV, parainfluenza virus; HAdV, human adenovirus; HMPV, human metapneumovirus; RSV, respiratory syncytial virus; HCoV, human coronavirus; HRV, human rhinovirus; HBoV, human bocavirus; S. pneumoniae, Streptococcus pneumoniae; S. pyogenes, Streptococcus pyogenes; S. aureus, Staphylococcus aureus; H. influenzae, Haemophilus influenzae; B. pertussis, Bordetella pertussis; E. coli, Escherichia coli; K. pneumoniae, Klebsiella pneumoniae; M. tuberculosis, Mycobacterium tuberculosis; P. aeruginosa, Pseudomonas aeruginosa; L. pneumophila, Legionella pneumophila; M. pneumoniae, Mycoplasma pneumoniae."

Figure 3

Seasonal and COVID-19 epidemic periodic distribution of respiratory pathogens A, proportion of seasons by pathogens infection; B, proportion of pathogens infection by season; C, proportion of COVID-19 epidemic periods by pathogens infection; D, proportion of pathogens infection by COVID-19 epidemic period. COVID-19, coronavirus disease 2019; FluA, influenza A virus; FluB, influenza B virus; PIV, parainfluenza virus; HAdV, human adenovirus; HMPV, human metapneumovirus; RSV, respiratory syncytial virus; HCoV, human coronavirus; HRV, human rhinovirus; HBoV, human bocavirus; S. pneumoniae, Streptococcus pneumoniae; S. pyogenes, Streptococcus pyogenes; S. aureus, Staphylococcus aureus; H. influenzae, Haemophilus influenzae; B. pertussis, Bordetella pertussis; E. coli, Escherichia coli; K. pneumoniae, Klebsiella pneumoniae; M. tuberculosis, Mycobacterium tuberculosis; P. aeruginosa, Pseudomonas aeruginosa; L. pneumophila, Legionella pneumophila; M. pneumoniae, Mycoplasma pneumoniae."

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