Pathogen spectrum analysis of hospitalized children with severe acute respiratory tract infection in Pudong New Area of Shanghai from 2018 to 2023

Objective To analyze the characteristics and epidemic patterns of the respiratory pathogen spectrum in hospitalized children with severe acute respiratory infection (SARI) in Pudong New Area from 2018 to 2023, and to provide a scientific basis for optimizing prevention and control strategies.Methods Real-time fluorescent quantitative PCR was used to detect common respiratory viruses in 1308 respiratory samples from hospitalized children.Results A total of 1,308 hospitalized children were included, with a virus detection rate of 23.62% (309/1,308). Among them, HRSV, HPIV, and HADV had relatively high proportions, accounting for 22.22% (64/288), 15.97% (46/288), and 15.27% (44/288), respectively. The rate of mixed infection was 1.61% (21/1,308), and 90.48% of the mixed infections were dual infections, mainly HADV and HPIV3 co-infection (14.3%, 3/21). The virus detection rate was the highest in the ≤1-year-old group (27.44%), significantly higher than that in the 11-15-year-old group (13.73%) (χ2 =17.29, P<0.05). The pathogen detection showed significant seasonal fluctuations, reaching a peak in spring (1-3 months) (32.18%) and a trough in autumn (7-9 months) (16.83%), with significant differences between seasons (χ2=10.40, P<0.05). There were significant changes in the pathogen detection rate between years (χ2=67.91, P<0.05).Conclusion The pathogen spectrum of SARI in hospitalized children in Pudong New Area is complex, with the main pathogens being respiratory syncytial virus, parainfluenza virus, and adenovirus. Mixed infections exist and the pathogen spectrum composition varies with the seasons. The prevalence of respiratory pathogens shows significant age distribution differences and seasonal dynamic characteristics. It is recommended to establish a seasonal early warning mechanism and strengthen the monitoring of key pathogens.