{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T03:45:07Z","timestamp":1787370307371,"version":"build-2736575974"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To address the research gap in the epidemiology of pediatric respiratory tract infections (RTIs) in Luzhou, Southern Sichuan, China, by analyzing respiratory pathogens in a large pediatric cohort from 2018 to 2021, covering the pre- and during-COVID-19 periods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study conducted a retrospective analysis of children with RTIs in Luzhou from July 2018 to January 2021. Strict exclusion criteria were applied to ensure an accurate representation of the pediatric population. Pathogen detection included viruses, bacteria, and atypical agents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Pathogens were identified in 52.8% of 12,546 cases. Viruses accounted for 32.2% of infections, bacteria for 29.8%, and atypical agents for 29.7%, with significant findings of <jats:italic>Staphylococcus aureus<\/jats:italic>, <jats:italic>Moraxella catarrhalis<\/jats:italic>, and <jats:italic>Mycoplasma pneumoniae<\/jats:italic>. Age-related analysis indicated a higher incidence of bacterial infections in infants and viral infections in preschool-aged children, with atypical pathogens being most prevalent in 3\u20135-year-olds. Gender-based analysis, adjusted for age, revealed similar overall pathogen presence; however, females were more susceptible to viral infections, while males were more prone to <jats:italic>Streptococcus pneumoniae<\/jats:italic>. Notably, there was an unusual increase in pathogen cases during spring, potentially influenced by behavioral changes and public health measures related to COVID-19. Co-infections were identified as a significant risk factor for the development of pneumonia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The study provides essential insights into the epidemiology of respiratory pathogens in pediatric populations, emphasizing the need for healthcare strategies tailored to age, gender, and seasonality. The findings highlight the impact of environmental and public health factors, including COVID-19 measures, on respiratory pathogen prevalence, underscoring the importance of targeted diagnostic and treatment protocols in pediatric respiratory infections.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2024.1374571","type":"journal-article","created":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T04:46:52Z","timestamp":1721191612000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Pediatric respiratory pathogen dynamics in Southern Sichuan, China: a retrospective analysis of gender, age, and seasonal trends"],"prefix":"10.3389","volume":"12","author":[{"given":"Qing","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinhuan","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengliang","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinbo","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,7,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1016\/s0140-6736(10)60060-8","article-title":"Causes of deaths in children younger than 5 years in China in 2008","volume":"375","author":"Rudan","year":"2010","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2047","DOI":"10.1016\/S0140-6736(22)00478-0","article-title":"Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis","volume":"399","author":"Li","year":"2022","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e33","DOI":"10.1016\/s2214-109x(20)30393-4","article-title":"Global burden of acute lower respiratory infection associated with human metapneumovirus in children under 5 years in 2018: a systematic review and modelling study","volume":"9","author":"Wang","year":"2021","journal-title":"Lancet Glob Health"},{"key":"B4","doi-asserted-by":"publisher","first-page":"290","DOI":"10.2471\/BLT.22.288614","article-title":"The who aware (access, watch, reserve) antibiotic book and prevention of antimicrobial resistance","volume":"101","author":"Zanichelli","year":"2023","journal-title":"Bull World Health Organ"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1533","DOI":"10.1016\/j.cmi.2022.08.009","article-title":"The WHO essential medicines list aware book: from a list to a quality improvement system","volume":"28","author":"Sharland","year":"2022","journal-title":"Clin Microbiol Infect"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2020.00308","article-title":"Modern tools for rapid diagnostics of antimicrobial resistance","volume":"10","author":"Vasala","year":"2020","journal-title":"Front Cell Infect Microbiol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"18315","DOI":"10.1038\/s41598-022-22792-y","article-title":"Rapid pathogen identification and phenotypic antimicrobial susceptibility directly from urine specimens","volume":"12","author":"Burg","year":"2022","journal-title":"Sci Rep"},{"key":"B8","doi-asserted-by":"publisher","first-page":"i2","DOI":"10.1093\/jac\/dky529","article-title":"Rapid microbial identification and antimicrobial susceptibility testing to drive better patient care: an evolving scenario","volume":"74","author":"\u00d6zenci","year":"2019","journal-title":"J Antimicrob Chemother"},{"key":"B9","doi-asserted-by":"publisher","first-page":"00113","DOI":"10.1183\/23120541.00113-2022","article-title":"Advances in diagnostic tools for respiratory tract infections: from tuberculosis to COVID-19\u2014changing paradigms?","volume":"8","author":"Stojanovic","year":"2022","journal-title":"ERJ Open Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"2437","DOI":"10.1002\/ppul.24922","article-title":"Prevalence and clinical significance of common respiratory pathogens in the upper respiratory tract of children with community-acquired pneumonia in Zunyi, China","volume":"55","author":"Li","year":"2020","journal-title":"Pediatr Pulmonol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1186\/s12887-018-1203-y","article-title":"Epidemiology and clinical characteristics of acute respiratory tract infections among hospitalized infants and young children in Chengdu, West China, 2009\u20132014","volume":"18","author":"Chen","year":"2018","journal-title":"BMC Pediatr"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e22302","DOI":"10.1016\/j.heliyon.2023.e22302","article-title":"Epidemiology of respiratory pathogens in patients with acute respiratory tract infection in Xiamen, China: a retrospective survey from 2020 to 2022","volume":"9","author":"Hong","year":"2023","journal-title":"Heliyon"},{"key":"B13","doi-asserted-by":"publisher","first-page":"e82","DOI":"10.1017\/s0950268823000626","article-title":"Prevalence of respiratory pathogens and risk of developing pneumonia under non-pharmaceutical interventions in Suzhou, China","volume":"151","author":"Shi","year":"2023","journal-title":"Epidemiol Infect"},{"key":"B14","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s12879-020-05720-1","article-title":"Epidemiology of viral respiratory infections in a pediatric reference hospital in central Panama","volume":"21","author":"N\u00fa\u00f1ez-Samudio","year":"2021","journal-title":"BMC Infect Dis"},{"key":"B15","doi-asserted-by":"publisher","first-page":"5026","DOI":"10.1038\/s41467-021-25120-6","article-title":"Etiological and epidemiological features of acute respiratory infections in China","volume":"12","author":"Li","year":"2021","journal-title":"Nat Commun"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1178636118758651","DOI":"10.1177\/1178636118758651","article-title":"Viral and bacterial etiologies of acute respiratory infections among children under 5 years in Senegal","volume":"11","author":"Assane","year":"2018","journal-title":"Microbiol Insights"},{"key":"B17","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1111\/jcpt.12610","article-title":"Antibacterials dispensed in the community comprise 85%\u201395% of total human antibacterial consumption","volume":"43","author":"Duffy","year":"2018","journal-title":"J Clin Pharm Ther"},{"key":"B18","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1080\/03007995.2019.1700947","article-title":"Ongoing strategies to improve the management of upper respiratory tract infections and reduce inappropriate antibiotic use particularly among lower and middle-income countries: findings and implications for the future","volume":"36","author":"Godman","year":"2020","journal-title":"Curr Med Res Opin"},{"key":"B19","doi-asserted-by":"publisher","first-page":"646","DOI":"10.3390\/antibiotics12040646","article-title":"Antibiotic overprescribing among neonates and children hospitalized with COVID-19 in Pakistan and the implications","volume":"12","author":"Mustafa","year":"2023","journal-title":"Antibiotics"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics11030315","article-title":"Changing epidemiology of respiratory tract infection during COVID-19 pandemic","volume":"11","author":"Tang","year":"2022","journal-title":"Antibiotics (Basel)"},{"key":"B21","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1016\/j.envres.2018.08.011","article-title":"The burden of overall and cause-specific respiratory morbidity due to ambient air pollution in Sichuan Basin, China: a multi-city time-series analysis","volume":"167","author":"Qiu","year":"2018","journal-title":"Environ Res"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1053","DOI":"10.3390\/healthcare9081053","article-title":"Spatial disparities in access to healthcare professionals in Sichuan: evidence from county-level data","volume":"9","author":"Zhang","year":"2021","journal-title":"Healthcare"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.629318","article-title":"Approach to identifying causative pathogens of community-acquired pneumonia in children using culture","volume":"9","author":"Mardian","year":"2021","journal-title":"Molecul Serolo Tests"},{"key":"B24","doi-asserted-by":"publisher","first-page":"39","DOI":"10.7883\/yoken.JJID.2017.323","article-title":"Epidemiology of respiratory pathogens in children with lower respiratory tract infections in Shanghai, China, from 2013 to 2015","volume":"71","author":"Liu","year":"2018","journal-title":"Jpn J Infect Dis"},{"key":"B25","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1007\/s00705-013-1863-8","article-title":"Association of meteorological factors with childhood viral acute respiratory infections in Subtropical China: an analysis over 11 years","volume":"159","author":"Chen","year":"2014","journal-title":"Arch Virol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1016\/j.jiph.2018.12.003","article-title":"The epidemiology and severity of respiratory viral infections in a tropical country: Ecuador, 2009\u20132016","volume":"12","author":"Caini","year":"2019","journal-title":"J Infect Public Health"},{"key":"B27","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1038\/s41581-023-00787-w","article-title":"Mechanisms and consequences of sex differences in immune responses","volume":"20","author":"Dunn","year":"2024","journal-title":"Nat Rev Nephrol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1111\/irv.12791","article-title":"Epidemiology of respiratory viruses in patients with severe acute respiratory infections and influenza-like illness in Suriname","volume":"15","author":"Grunberg","year":"2021","journal-title":"Influenza Other Respir Viruses"},{"key":"B29","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1186\/1471-2334-14-373","article-title":"Viral etiology and seasonality of influenza-like illness in Gabon, march 2010 to June 2011","volume":"14","author":"Lekana-Douki","year":"2014","journal-title":"BMC Infect Dis"},{"key":"B30","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1111\/irv.12348","article-title":"Early occurrence of influenza a epidemics coincided with changes in occurrence of other respiratory virus infections","volume":"10","author":"van Asten","year":"2016","journal-title":"Influenza Other Respir Viruses"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12879-017-2888-5","article-title":"Possible interference between seasonal epidemics of influenza and other respiratory viruses in Hong Kong, 2014\u20132017","volume":"17","author":"Zheng","year":"2017","journal-title":"BMC Infect Dis"},{"key":"B32","doi-asserted-by":"publisher","first-page":"19354","DOI":"10.2807\/ese.14.40.19354-en","article-title":"Does viral interference affect spread of influenza?","volume":"14","author":"Linde","year":"2009","journal-title":"Eurosurveillance"},{"key":"B33","doi-asserted-by":"publisher","first-page":"3331","DOI":"10.1016\/S0264-410X(01)00028-7","article-title":"Neonatal and early life vaccinology","volume":"19","author":"Siegrist","year":"2001","journal-title":"Vaccine"},{"key":"B34","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1056\/NEJM197602192940803","article-title":"Respiratory syncytial virus infections within families","volume":"294","author":"Hall","year":"1976","journal-title":"N Engl J Med"},{"key":"B35","doi-asserted-by":"publisher","first-page":"20143085","DOI":"10.1098\/rspb.2014.3085","article-title":"Evolution of the immune system in humans from infancy to old age","volume":"282","author":"Simon","year":"2015","journal-title":"Proc Biol Sci"},{"key":"B36","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1186\/s12879-019-3689-9","article-title":"Temporal patterns of influenza a subtypes and B lineages across age in a subtropical city, during pre-pandemic, pandemic, and post-pandemic seasons","volume":"19","author":"Zhou","year":"2019","journal-title":"BMC Infect Dis"},{"key":"B37","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1002\/ppul.26664","article-title":"Environmental risk factors for respiratory infection and wheeze in young children: a multicentre birth cohort study","volume":"59","author":"Ruffles","year":"2024","journal-title":"Pediatr Pulmonol"},{"key":"B38","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1038\/s41390-020-01233-4","article-title":"Risk factors for recurrent respiratory tract infection in preschool-aged children","volume":"90","author":"Zhou","year":"2021","journal-title":"Pediatr Res"},{"key":"B39","doi-asserted-by":"publisher","first-page":"1545","DOI":"10.1016\/S0140-6736(10)60206-1","article-title":"Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis","volume":"375","author":"Nair","year":"2010","journal-title":"Lancet"},{"key":"B40","doi-asserted-by":"publisher","first-page":"e15352","DOI":"10.15252\/emmm.202115352","article-title":"Seasonality of influenza and other respiratory viruses","volume":"14","author":"Neumann","year":"2022","journal-title":"EMBO Mol Med"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2023.1112150","article-title":"The surge of RSV and other respiratory viruses among children during the second COVID-19 pandemic winter season","volume":"11","author":"Riepl","year":"2023","journal-title":"Front Pediatr"},{"key":"B42","doi-asserted-by":"publisher","first-page":"1936","DOI":"10.3390\/microorganisms10101936","article-title":"Sars-Cov-2: the impact of co-infections with particular reference to Mycoplasma pneumonia-a clinical review","volume":"10","author":"Marino","year":"2022","journal-title":"Microorganisms"},{"key":"B43","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1002\/jmv.27324","article-title":"Atypical bacterial co-infections among patients with COVID-19: a study from India","volume":"94","author":"Chaudhry","year":"2022","journal-title":"J Med Virol"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1374571\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T04:46:55Z","timestamp":1721191615000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1374571\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,17]]},"references-count":43,"alternative-id":["10.3389\/fped.2024.1374571"],"URL":"https:\/\/doi.org\/10.3389\/fped.2024.1374571","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,17]]},"article-number":"1374571"}}