[Pathogen spectrum characteristics and influencing factors of recurrent respiratory infection in children in the Shenzhen community during winter and spring]

Abstract

Objective: To understand the pathogen spectrum characteristics of recurrent respiratory tract infection in children in the Shenzhen community during winter and spring, and to explore the influencing factors, to provide a scientific basis for accurate disease prevention and control strategies. Methods: Children under 14 years old were recruited from four districts in Shenzhen for cohort follow-up by a three-stage stratified cluster random sampling method from October 2023 to April 2024. Structured questionnaires were used to conduct symptom surveys, and throat swabs were collected to detect 24 common respiratory pathogens. A multilevel random- intercept mixed-effects model was constructed to examine the factors influencing recurrent respiratory infections in children in the Shenzhen community. Results: A total of 219 children in the Shenzhen community were included, with a M(Q₁, Q₃) age of 9.0 (6.0, 11.0) years. The incidence rate of total respiratory symptoms and the positive detection rate of any respiratory pathogen were 6.6% (96/1 463) and 14.3% (217/1 517), respectively. The incidence rate of recurrent respiratory symptoms and the positive detection rate of recurrent respiratory pathogens were 7.2% (15/208) and 11.5% (25/218), respectively. The incidence rate of recurrent respiratory symptoms in urban villages was higher than that in old and urban communities (χ²=14.81, P=0.001). When the number of children in the family was more than 2, or the family had recurrent respiratory symptoms, the incidence rate of recurrent respiratory symptoms in children was higher (χ²=13.03, P<0.001; χ²=16.27, P=0.001). The common pathogens detected in children in the Shenzhen community were rhinovirus (6.9%, 105/1 517), Mycoplasma pneumoniae (2.0%, 31/1 517), and adenovirus (1.5%, 22/1 517). Streptococcus pneumoniae and respiratory syncytial virus were mainly detected in children under 5 years old, and Mycoplasma pneumoniae was mainly detected in children aged 5-13 years. The detection rate of Mycoplasma pneumoniae was higher in December (3.7%, 8/219), and those of adenovirus (5.9%, 13/219) and Streptococcus pneumoniae (5.0%, 11/219) were higher in January. The family-individual two-level model showed strong family aggregation of recurrent respiratory symptoms in children (intraclass correlation coefficient=0.999), and boys had a higher likelihood of recurrent respiratory symptoms than girls (Z=-1.74, P=0.081). Conclusions: Rhinovirus and Mycoplasma pneumoniae were the main pathogens of recurrent respiratory infections in children in the Shenzhen community during winter and spring, and were influenced by age, gender, season, community type, and family aggregation. Other family-related environmental factors deserve further exploration.