title: New Epidemiological and Clinical Signatures of 18 Pathogens from Respiratory Tract Infections Based on a 5-Year Study.
abstract: BACKGROUND
  Respiratory tract infections (RTIs) are a heavy burden on society. However, due to the complex etiology of RTIs, the clinical diagnosis, treatment, and prevention of these infections remain challenging, especially in developing countries.
  
  
  METHODS
  To determine the epidemiological and clinical characteristics of 18 respiratory pathogens, we analyzed 12,502 patients with acute respiratory infections (ARIs) by performing polymerase chain reaction (PCR) on patient pharyngeal swabs.
  
  
  RESULTS
  Samples positive for at least 1 pathogen were obtained from 48.42% of the total patients. Of these pathogen-positive patients, 17.99% were infected with more than 1 pathogen. Of the 18 pathogens analyzed, four were detected with a positive detection rate (PDR) > 5%: influenza A virus (IAV) > respiratory syncytial virus (RSV) >Mycoplasma pneumoniae (MP) > human coronavirus (HCoV). The pathogens with the 4 highest co-infection rates (CIRs) were as follows: HCoV > human bocavirus (HBoV) > enterovirus (EV) > parainfluenza virus (PIV). The overall positive detection rate (PDR) varied significantly according to patient age, the season and year of detection, and the disease subgroup, but not according to patient sex. The individual PDRs of the pathogens followed 3 types of distributions for patient sex, 4 types of distributions for patient age, 4 types of seasonal distributions, 2 types of seasonal epidemic trends, 4 types of yearly epidemic trends, and different susceptibility distributions in the disease subgroups. Additionally, the overall CIR showed significantly different distributions according to patient sex, patient age, and the disease subgroup, whereas the CIRs of individual pathogens suggested significant preference characteristics.
  
  
  CONCLUSIONS
  IAV remains the most common pathogen among the pathogens analyzed. More effort should be directed toward the prevention and control of pathogens that show a trend of increasing incidence such as HCoV, human adenovirus (ADV), and RSV. Although clinically distinguishing specific pathogens responsible for RTIs is difficult, the epidemiological and clinical characteristics of the various RTI-causing agents could provide clues for clinicians, thereby informing decisions regarding prevention and medication and guiding appropriate public health strategies.
authors.affiliation: State Key Laboratory of Respiratory Diseases, Guangzhou Medical University, Guangzhou, Guangdong, China; The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Liao
authors.affiliation: Department of Orthopedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Zhengbo
authors.initials: Z
authors.lastname: Hu
authors.affiliation: State Key Laboratory of Respiratory Diseases, Guangzhou Medical University, Guangzhou, Guangdong, China; The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors.forename: Wenkuan
authors.initials: W
authors.lastname: Liu
authors.affiliation: State Key Laboratory of Respiratory Diseases, Guangzhou Medical University, Guangzhou, Guangdong, China; The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Lu
authors.affiliation: The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors.forename: Dehui
authors.initials: D
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Respiratory Diseases, Guangzhou Medical University, Guangzhou, Guangdong, China; The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors.forename: Meixin
authors.initials: M
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Respiratory Diseases, Guangzhou Medical University, Guangzhou, Guangdong, China; The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors.forename: Shuyan
authors.initials: S
authors.lastname: Qiu
authors.affiliation: State Key Laboratory of Respiratory Diseases, Guangzhou Medical University, Guangzhou, Guangdong, China; The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors.forename: Zhiqi
authors.initials: Z
authors.lastname: Zeng
authors.affiliation: State Key Laboratory of Respiratory Diseases, Guangzhou Medical University, Guangzhou, Guangdong, China; The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors.forename: Xingui
authors.initials: X
authors.lastname: Tian
authors.affiliation: State Key Laboratory of Respiratory Diseases, Guangzhou Medical University, Guangzhou, Guangdong, China; The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Cui
authors.affiliation: State Key Laboratory of Respiratory Diseases, Guangzhou Medical University, Guangzhou, Guangdong, China; The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D000328:Adult; D001419:Bacteria / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000382:microbiology*; D012141:Respiratory Tract Infections / Q000145:classification* / Q000453:epidemiology* / Q000382:microbiology; D012621:Seasons; D014780:Viruses / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D055815:Young Adult