{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:15:50Z","timestamp":1788419750282,"version":"build-2803163510"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"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. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Acute respiratory infections are a major public health problem in children. The epidemiology of pediatric respiratory pathogens has shifted in recent years. This study aimed to compare the epidemiological patterns of six common respiratory pathogens among children with acute respiratory infections (ARI) in Xiamen and Linxia, China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study included 5,835 children with ARI from December 2024 to November 2025. Oropharyngeal swabs were tested for rhinovirus (RV), respiratory syncytial virus (RSV), influenza A virus (Flu A), influenza B virus (Flu B), adenovirus (ADV), and\n                      <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      (MP) using multiplex RT-PCR. Detection rates were compared by region, sex, age group and season.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 3,143 samples (53.9%) were positive; 290 (5.0%) had co-detections. RV (23.8%), RSV (20.2%) and Flu A (8.8%) were most frequently detected. Positivity was higher in Linxia than in Xiamen (65.4% vs. 49.0%;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). After adjustment, Linxia remained associated with higher odds of detection (aOR 1.86, 95% CI 1.65\u20132.10). Detection was also associated with male sex, toddler\/preschool age and autumn\/winter seasons.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RV, RSV and Flu A were the most frequently detected pathogens in both regions. The findings indicate regional, age-related and seasonal heterogeneity, supporting locally tailored surveillance and prevention planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1926943","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:40:16Z","timestamp":1788417616000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative epidemiology of six respiratory pathogens among children aged 28\u202fdays to 14\u202fyears with acute respiratory infections in coastal Xiamen and inland Linxia, China: a multicenter retrospective study"],"prefix":"10.3389","volume":"14","author":[{"given":"Xingxiang","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Fujian Key Clinical Specialty of Laboratory Medicine, Women and Children\u2019s Hospital, School of Medicine, Xiamen University","place":["Xiamen, China"]},{"name":"State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Life Sciences, School of Public Health, Xiamen University","place":["Xiamen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongmei","family":"Ma","sequence":"additional","affiliation":[{"name":"Linxia Hui Autonomous Prefecture Maternal and Child Health Hospital","place":["Linxia, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiali","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Fujian Key Clinical Specialty of Laboratory Medicine, Women and Children\u2019s Hospital, School of Medicine, Xiamen University","place":["Xiamen, China"]},{"name":"State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Life Sciences, School of Public Health, Xiamen University","place":["Xiamen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jumei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Fujian Key Clinical Specialty of Laboratory Medicine, Women and Children\u2019s Hospital, School of Medicine, Xiamen University","place":["Xiamen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Fujian Key Clinical Specialty of Laboratory Medicine, Women and Children\u2019s Hospital, School of Medicine, Xiamen University","place":["Xiamen, China"]},{"name":"State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Life Sciences, School of Public Health, Xiamen University","place":["Xiamen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qunshan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Fujian Key Clinical Specialty of Laboratory Medicine, Women and Children\u2019s Hospital, School of Medicine, Xiamen University","place":["Xiamen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Fujian Key Clinical Specialty of Laboratory Medicine, Women and Children\u2019s Hospital, School of Medicine, Xiamen University","place":["Xiamen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiqiang","family":"Han","sequence":"additional","affiliation":[{"name":"Linxia Hui Autonomous Prefecture Maternal and Child Health Hospital","place":["Linxia, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiming","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Fujian Key Clinical Specialty of Laboratory Medicine, Women and Children\u2019s Hospital, School of Medicine, Xiamen University","place":["Xiamen, China"]},{"name":"State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Life Sciences, School of Public Health, Xiamen University","place":["Xiamen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.mib.2016.11.003","article-title":"Viral-bacterial co-infections in the respiratory tract","volume":"35","author":"Bakaletz","year":"2017","journal-title":"Curr Opin Microbiol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1002\/jmv.25674","article-title":"Recent advances in the detection of respiratory virus infection in humans","volume":"92","author":"Zhang","year":"2020","journal-title":"J Med Virol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the global burden of disease study 2019","volume":"396","year":"2019","journal-title":"Lancet"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1056\/NEJMoa1500245","article-title":"Community-acquired pneumonia requiring hospitalization among U.S. adults","volume":"373","author":"Jain","year":"2015","journal-title":"N Engl J Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"21860","DOI":"10.1038\/s41598-023-48814-x","article-title":"Multicenter study to describe viral etiologies, clinical profiles, and outcomes of hospitalized children with severe acute respiratory infections, Egypt 2022","volume":"13","author":"Kandeel","year":"2023","journal-title":"Sci Rep"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1633","DOI":"10.1002\/jmv.25502","article-title":"The spectrum of viral pathogens in children with severe acute lower respiratory tract infection: a 3-year prospective study in the pediatric intensive care unit","volume":"91","author":"Li","year":"2019","journal-title":"J Med Virol"},{"key":"ref7","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":"ref8","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1128\/CMR.00114-16","article-title":"Mycoplasma pneumoniae from the respiratory tract and beyond","volume":"30","author":"Waites","year":"2017","journal-title":"Clin Microbiol Rev"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1038\/s41598-022-26184-0","article-title":"Air quality, meteorological variability and pediatric respiratory syncytial virus infections in Singapore","volume":"13","author":"Lee","year":"2023","journal-title":"Sci Rep"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e154","DOI":"10.1016\/S2542-5196(20)30297-7","article-title":"Seasonal association between viral causes of hospitalised acute lower respiratory infections and meteorological factors in China: a retrospective study","volume":"5","author":"Xu","year":"2021","journal-title":"Lancet Planet Health"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1186\/s12985-024-02579-5","article-title":"Epidemiological characteristics of respiratory pathogens infections among children after the removal of non-pharmaceutical interventions in Central China","volume":"21","author":"Liu","year":"2024","journal-title":"Virol J"},{"key":"ref12","volume-title":"National Economic and Social Development Statistical Communiqu\u00e9 of Xiamen","year":"2025"},{"key":"ref13","volume-title":"National Economic and Social Development Statistical Communiqu\u00e9 of Linxia Hui Autonomous Prefecture","year":"2025"},{"key":"ref14","volume-title":"Revised WHO Classification and Treatment of Pneumonia in Children at Health Facilities: Evidence Summaries","year":"2014"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1038\/s41467-021-21157-9","article-title":"Impact of the COVID-19 nonpharmaceutical interventions on influenza and other respiratory viral infections in New Zealand","volume":"12","author":"Huang","year":"2021","journal-title":"Nat Commun"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e1003194","DOI":"10.1371\/journal.ppat.1003194","article-title":"Environmental predictors of seasonal influenza epidemics across temperate and tropical climates","volume":"9","author":"Tamerius","year":"2013","journal-title":"PLoS Pathog"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"30547","DOI":"10.1073\/pnas.2013182117","article-title":"The impact of COVID-19 nonpharmaceutical interventions on the future dynamics of endemic infections","volume":"117","author":"Baker","year":"2020","journal-title":"Proc Natl Acad Sci USA"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"3481","DOI":"10.1111\/ajt.16049","article-title":"Changes in influenza and other respiratory virus activity during the COVID-19 pandemic-United States, 2020-2021","volume":"21","author":"Olsen","year":"2021","journal-title":"Am J Transplant"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1186\/s12887-021-02759-0","article-title":"Epidemiological and clinical characteristics of respiratory viruses in 4403 pediatric patients from multiple hospitals in Guangdong, China","volume":"21","author":"Zhang","year":"2021","journal-title":"BMC Pediatr"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"e0055121","DOI":"10.1128\/Spectrum.00551-21","article-title":"Viral and atypical bacterial detection in young Nepalese children hospitalized with severe pneumonia","volume":"9","author":"Mathisen","year":"2021","journal-title":"Microbiol Spectrum"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1502036","DOI":"10.3389\/fpubh.2025.1502036","article-title":"Sex differences in acute respiratory tract infections-multi-year analysis based on data from a large tertiary care medical center in Israel","volume":"13","author":"Peer","year":"2025","journal-title":"Front Public Health"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1845","DOI":"10.1016\/j.rmed.2007.04.011","article-title":"Sex differences in the incidence and severity of respiratory tract infections","volume":"101","author":"Falagas","year":"2007","journal-title":"Respir Med"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1038\/nri.2016.90","article-title":"Sex differences in immune responses","volume":"16","author":"Klein","year":"2016","journal-title":"Nat Rev Immunol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1146\/annurev-virology-012420-022445","article-title":"Seasonality of respiratory viral infections","volume":"7","author":"Moriyama","year":"2020","journal-title":"Annu Rev Virol"},{"key":"ref25","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":"ref26","doi-asserted-by":"publisher","first-page":"1356","DOI":"10.1093\/infdis\/jiy056","article-title":"Respiratory syncytial virus seasonality: a global overview","volume":"217","author":"Obando-Pacheco","year":"2018","journal-title":"J Infect Dis"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1926943\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:40:18Z","timestamp":1788417618000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1926943\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":26,"alternative-id":["10.3389\/fpubh.2026.1926943"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1926943","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,3]]},"article-number":"1926943"}}