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Background <p>To investigate the characteristics of co-infection pathogen profiles in children with adenovirus pneumonia and provide guidance for clinical diagnosis and rational treatment.</p> Methods <p>A retrospective analysis was conducted on the etiological results of co-infections in children hospitalized with adenovirus pneumonia in the Respiratory Department of Hebei Children’s Hospital from January 1, 2024, to December 31, 2024. Differences in co-infections across genders, age groups, and seasons were analyzed.</p> Results <p>Among 5,373 children hospitalized with community-acquired pneumonia, 330 cases (6.1%) were diagnosed with adenovirus pneumonia, of which 310 (93.9%) exhibited co-infections. Bacterial co-infections predominated (70.0%, 231/330), with <i>Streptococcus pneumoniae</i> (45.2%), <i>Haemophilus influenzae</i> (40.9%), and <i>Moraxella catarrhalis</i> (2.7%) being among the most frequently detected, followed by <i>Staphylococcus aureus</i> (2.4%), <i>Bordetella pertussis</i> (2.1%), <i>Pseudomonas aeruginosa</i>, <i>Enterobacter cloacae</i>, and <i>Streptococcus pyogenes</i>. Viral co-infections were identified in 45.5% (150/330), primarily rhinovirus (26.4%), influenza A/B (7.3%), parainfluenza virus (5.8%), respiratory syncytial virus (RSV, 4.8%), metapneumovirus (4.5%), coronavirus (1.5%), and bocavirus (0.3%). Additionally, <i>Mycoplasma pneumoniae</i> co-infections accounted for 44.5% (147/330). Gender-specific analysis revealed significantly higher RSV co-infection rates in girls than boys (<i>P</i> &lt; 0.05), with no notable gender disparities for other pathogens. Age-related differences showed higher bacterial co-infection rates in infants/toddlers compared to preschool/school-age groups (<i>P</i> &lt; 0.05), where <i>Streptococcus pneumoniae</i> peaked in infants/toddlers, parainfluenza virus was most frequent in infants/toddlers, and <i>Mycoplasma pneumoniae</i> predominated in school-age children. Seasonally, co-infection rates remained consistent year-round, though RSV and influenza A/B peaked in winter, parainfluenza virus in summer, metapneumovirus was least detected in summer, and <i>Mycoplasma pneumoniae</i> exhibited the highest positivity in autumn and the lowest in spring.</p> Conclusion <p>Adenovirus pneumonia in children in this region exhibits a high rate of co-infections, predominantly bacterial (especially <i>Streptococcus pneumoniae</i> and <i>Haemophilus influenzae</i>), followed by viral (rhinovirus, influenza, parainfluenza, RSV) and <i>Mycoplasma pneumoniae</i>. Co-infection profiles vary by gender, age, and season. Timely identification of co-pathogens is critical for guiding rational antimicrobial use and improving prognosis.</p>

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High prevalence and pathogen-specific variations of co-infections in pediatric adenovirus pneumonia: a retrospective epidemiological analysis from Northern China

  • 期刊论文

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  • 发表日期：

    2025年11月14日

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  • Yanmei Lang,
  • Cuijie Gong,
  • Dandan Li

摘要

Background

To investigate the characteristics of co-infection pathogen profiles in children with adenovirus pneumonia and provide guidance for clinical diagnosis and rational treatment.

Methods

A retrospective analysis was conducted on the etiological results of co-infections in children hospitalized with adenovirus pneumonia in the Respiratory Department of Hebei Children’s Hospital from January 1, 2024, to December 31, 2024. Differences in co-infections across genders, age groups, and seasons were analyzed.

Results

Among 5,373 children hospitalized with community-acquired pneumonia, 330 cases (6.1%) were diagnosed with adenovirus pneumonia, of which 310 (93.9%) exhibited co-infections. Bacterial co-infections predominated (70.0%, 231/330), with Streptococcus pneumoniae (45.2%), Haemophilus influenzae (40.9%), and Moraxella catarrhalis (2.7%) being among the most frequently detected, followed by Staphylococcus aureus (2.4%), Bordetella pertussis (2.1%), Pseudomonas aeruginosa, Enterobacter cloacae, and Streptococcus pyogenes. Viral co-infections were identified in 45.5% (150/330), primarily rhinovirus (26.4%), influenza A/B (7.3%), parainfluenza virus (5.8%), respiratory syncytial virus (RSV, 4.8%), metapneumovirus (4.5%), coronavirus (1.5%), and bocavirus (0.3%). Additionally, Mycoplasma pneumoniae co-infections accounted for 44.5% (147/330). Gender-specific analysis revealed significantly higher RSV co-infection rates in girls than boys (P < 0.05), with no notable gender disparities for other pathogens. Age-related differences showed higher bacterial co-infection rates in infants/toddlers compared to preschool/school-age groups (P < 0.05), where Streptococcus pneumoniae peaked in infants/toddlers, parainfluenza virus was most frequent in infants/toddlers, and Mycoplasma pneumoniae predominated in school-age children. Seasonally, co-infection rates remained consistent year-round, though RSV and influenza A/B peaked in winter, parainfluenza virus in summer, metapneumovirus was least detected in summer, and Mycoplasma pneumoniae exhibited the highest positivity in autumn and the lowest in spring.

Conclusion

Adenovirus pneumonia in children in this region exhibits a high rate of co-infections, predominantly bacterial (especially Streptococcus pneumoniae and Haemophilus influenzae), followed by viral (rhinovirus, influenza, parainfluenza, RSV) and Mycoplasma pneumoniae. Co-infection profiles vary by gender, age, and season. Timely identification of co-pathogens is critical for guiding rational antimicrobial use and improving prognosis.