{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T18:02:12Z","timestamp":1781028132933,"version":"3.54.1"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002842","name":"Chiang Mai University","doi-asserted-by":"publisher","award":["None"],"award-info":[{"award-number":["None"]}],"id":[{"id":"10.13039\/501100002842","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The COVID-19 pandemic disrupted the circulation patterns of respiratory viruses. In tropical regions like Thailand, ongoing surveillance is essential to understand the etiology of severe acute respiratory infections (SARIs) in the post-pandemic era. We investigated the etiology of SARI among hospitalized adults in the post-pandemic era.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective analysis of respiratory samples collected from adult patients (\u226518 years) who were hospitalized at a regional hospital in Chiang Mai, Thailand, between November 2023 and April 2024 due to symptoms of SARI (fever of \u226538\u00b0C, cough, and onset within 10 days). Sputum and\/or nasopharyngeal swab were collected at admission and tested using a multiplex real-time PCR assay targeting 22 respiratory viruses and\n                      <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      (Siemens Healthineers Fast Track Diagnostics and Tellgen SARS-CoV-2 Nucleic Acid Detection Kit). Demographic, clinical, treatment, and comorbidity data were extracted from hospital records, and descriptive statistics were used to summarize patient characteristics and pathogen distribution.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 101 hospitalized SARI patients (median age 62 years (interquartile range 43\u201371); 57 males), 47 (47%) tested positive for at least one respiratory pathogen. The most frequently detected viruses were adenovirus (17\/101, 17%) and rhinovirus (13\/101, 13%). Co-infections occurred in 9% (9\/101) of cases. Seasonal trends showed peaks of influenza A and rhinovirus in January, while adenovirus and enterovirus circulated consistently throughout the study period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Nearly half of adult SARI cases were associated with viral pathogens. Other SARI etiologies could be due to bacterial or fungal infections not tested in our study. The high rate of empiric antibiotic use highlights the need for broader and rapid molecular diagnostics. Enhanced pathogen-specific surveillance is essential to guide evidence-based clinical management in the post-pandemic context.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0350198","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T17:24:01Z","timestamp":1781025841000},"page":"e0350198","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Etiology of severe acute respiratory infections among adults in northern Thailand using multiplex PCR: A post-COVID-19 surveillance study (2023\u20132024)"],"prefix":"10.1371","volume":"21","author":[{"given":"Nang","family":"Kham-Kjing","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rathakarn","family":"Kawila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patcharaporn","family":"Tariyo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kittiyaporn","family":"Puapun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirinat","family":"Wongchotbrorirak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Ngo-Giang-Huong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayamon","family":"Hongjaisee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0196-5691","authenticated-orcid":true,"given":"Woottichai","family":"Khamduang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"issue":"1","key":"pone.0350198.ref001","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/S1473-3099(01)00170-0","article-title":"Estimates of world-wide distribution of child deaths from acute respiratory infections","volume":"2","author":"BG Williams","year":"2002","journal-title":"Lancet Infect Dis"},{"issue":"11","key":"pone.0350198.ref002","doi-asserted-by":"crossref","DOI":"10.1016\/j.heliyon.2023.e22300","article-title":"Epidemiology and clinical characteristics of severe acute respiratory infections among hospitalized children under 5 years of age in a tertiary care center in Bangkok, Thailand, 2019-2020","volume":"9","author":"N Wanlapakorn","year":"2023","journal-title":"Heliyon"},{"issue":"3","key":"pone.0350198.ref003","article-title":"Etiological and epidemiological characteristics of severe acute respiratory infection caused by multiple viruses and Mycoplasma pneumoniae in adult patients in Jinshan, Shanghai: A pilot hospital-based surveillance study","volume":"16","author":"J Li","year":"2021","journal-title":"PLoS One"},{"issue":"3","key":"pone.0350198.ref004","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1093\/trstmh\/trac074","article-title":"Clinical and epidemiological aspects of severe acute respiratory infection: before and during the first year of the COVID-19 pandemic in Brazil","volume":"117","author":"FC de Carvalho","year":"2023","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"pone.0350198.ref005","unstructured":"World Health Organization. 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