Analysis of the pathogenic spectrum and epidemiological characteristics of 22 respiratory pathogens in Zhuhai City, China, 2024–2025

Abstract

Abstract Objectives Effective surveillance of respiratory infectious diseases is crucial for precise prevention and evidence-based public health response. This study analyzed the etiological spectrum of respiratory pathogens in Zhuhai, a high-mobility port city, from January 2024 to December 2025. Methods Throat swab specimens from national sentinel influenza-like illness (ILI) cases and hospitalized severe acute respiratory infection (SARI) cases were tested for 22 pathogens using real-time PCR. Descriptive epidemiological methods were applied. Results Among 2,788 patients, the overall pathogen positivity rate was 64.56%. Twenty pathogens were identified, with Streptococcus pneumoniae (SP), Haemophilus influenzae (Hi), human rhinovirus (HRV), influenza A virus (FluA), human adenovirus (ADV), and Mycoplasma pneumoniae (MP) being the most prevalent. Mixed infections accounted for 48.28% of positive samples, with SP + Hi as the most common combination. Positivity rates for HRV, SP, and Hi were significantly higher in males, while MP was higher in females. Children aged 0–14 years constituted 96.11% of positive cases, with the highest rate in the 4–14 years group. Monthly trends showed SP and Hi were persistently dominant with synchronized peaks. FluA exhibited several epidemic peaks. HRV circulated sporadically, while MP and ADV peaked from May to September 2024. Conclusions In this study, multiple respiratory pathogens co-circulated in Zhuhai during 2024–2025, with distinct patterns by sex, age, and season. Children under 15 were the primary affected population, highlighting the need for targeted surveillance in this group.