ObjectiveTo report a case of severe Mycoplasma pneumoniae pneumonia complicated with necrotizing laryngotracheobronchitis, and to detail its clinical manifestations, auxiliary examinations and treatment process, so as to enhance clinicians’ understanding of necrotizing laryngotracheobronchitis and emphasize the indispensable role of bronchoscopy in the diagnosis and treatment of necrotizing laryngotracheobronchitis.MethodsReport on a child with severe Mycoplasma pneumoniae pneumonia complicated by necrotizing laryngotracheobronchitis; the child was a 7 - year - old boy; the clinical features included recurrent high fever, cough and hoarseness; physical examination revealed fair spirits, pharyngeal congestion, grade I tonsillar enlargement, coarse breath sounds in both lungs, and no rales heard; auxiliary examinations confirmed Mycoplasma pneumoniae infection; under bronchoscopy, necrosis of the bronchial mucosa and exposure of cartilage were observed, and the pathological examination of the lesion showed inflammatory necrosis; after anti - infection treatment and multiple bronchoscopic lavage treatments, the child's condition improved and he was discharged from the hospital.ConclusionNecrotizing laryngotracheobronchitis can present with diffuse necrosis of the airway mucosa, has an acute onset and a severe disease progression, and can lead to death; in this case, the child developed necrosis of the tracheal and bronchial mucosa after Mycoplasma pneumoniae infection, and there is currently no report of necrotizing laryngotracheobronchitis occurring after Mycoplasma pneumoniae infection; in treatment, anti - infection treatment should be combined with bronchoscopic lavage treatment.

Objective This study aims to investigate the characteristics of bacterial microbiome in the nasopharynx of children with bronchiolitis and their correlation with recurrent wheezing. Methods The study enrolled children clinically diagnosed with bronchiolitis who were hospitalized in the Respiratory Department of Children's Hospital of Soochow University from October 2021 to March 2022. And we collected their demographic information, clinical data, and laboratory examinations. We collected nasopharyngeal secretions for pathogen examination and nasopharyngeal swabs for detection of nasopharyngeal bacterial microbiome using 16S rDNA sequencing analysis technology. A one-year follow-up was conducted after the children's discharge from the hospital. Based on the occurrence of recurrent wheezing, the children were classified into two groups: recurrent wheezing group and non-recurrent wheezing group. The study aimed to identify differences in pathogens, bacterial microbiome, and other aspects between the two groups. Results There are 13 cases (33.3%) of Human Rhinovirus(HRV) infection in the recurrent wheezing group, which is higher than the 7 cases (13.7%) in the non-recurrent wheezing group( χ 2 = 4.9, P = 0.027). At the genus level, the median abundance of Moraxella in the recurrent wheezing group was 9.2% (0.43, 41%), which was higher than that in the non-recurrent wheezing group at 0.16% (0.09, 0.36%) ( Z =-6.1, P <0.001). Logistic regression analysis showed that eosinophilia count (OR = 49.76, 95% CI 1.2–2018), HRV infection (OR = 13.5, 95% CI 2.6–69), and high abundance of Moraxella catarrhalis in the nasopharynx (OR = 5.2, 95% CI 1.1-25.04) were risk factors for recurrent wheezing in children with bronchiolitis ( p -values were 0.039, 0.002, and 0.041, respectively). Conclusion HRV infection and a high abundance of Moraxella catarrhalis in the nasopharynx are risk factors for subsequent recurrent wheezing in children with bronchiolitis.

Background:This study aimed to investigate characteristic changes in the upper respiratory tract (URT) microbiome and metabolome in children with asthma and explore their associations with lung function. Methods:Children with asthma aged 6 years and above admitted to the Children's Hospital of Soochow University from December 2022 to December 2023 comprised the study group. Age-matched healthy children undergoing physical examinations in the Department of Child Health were recruited as controls. Throat swabs were collected for microbiome detection using 16S rDNA sequencing and metabolomics analysis using liquid chromatography-mass spectrometry (LC-MS). Results:(1) Significant differences in alpha and beta diversity were observed among the control group (H), chronic persistent asthma group (CA), and acute exacerbation group (AA). In both CA and AA groups, FVC% predicted (FVC%/Pred) and FEV1% predicted (FEV1%/Pred) were negatively correlated with URT microbiota abundance. Actinobacillus abundance was positively correlated with FEV1%/Pred, FEV1/FVC, FEF25%/Pred, FEF50%/Pred, and FEF75%/Pred. (2) Metabolite differences between CA and AA groups were analyzed, and the top 5 differential metabolites were evaluated for their accuracy as asthma assessment biomarkers. L-carnitine showed an AUC > 0.9, with a sensitivity of 85.7% and specificity of 85%. Other differential metabolites, including monoisobutyl phthalate, 4-hexyl-2,5-dimethyloxazole, and dibutyl phthalate, correlated with several lung function indices. The most relevant differential metabolic pathways included arginine biosynthesis, alanine-aspartate-glutamate metabolism, central carbon metabolism in cancer, and D-amino acid metabolism. Conclusion:The URT microbiota in asthmatic children exhibits alterations in composition, structure, and diversity, with lower diversity in acute asthma compared to chronic persistent asthma. At the genus level, some microbiota (Actinobacillus, Fusobacterium) were correlated with FEV1%/Pred, FEV1/FVC, FEF25%/Pred, FEF50%/Pred, FEF75%/Pred. The differential metabolite L-carnitine may be a potential biomarker for asthma assessment.

Pertussis, caused by Bordetella pertussis, remains a substantial public health threat despite long-standing vaccination programs. Widespread non-pharmaceutical interventions (NPIs) during COVID-19 were accompanied by marked declines in reported pertussis activity in many settings. However, relaxation of containment measures has been followed by resurgence, characterized by atypical outbreak patterns and shifts in case distribution, bacterial genotypes, and affected populations. Emerging evidence suggests that these changes are multifactorial, including altered contact patterns and immunity gap, disruptions and recovery in routine immunization and surveillance, waning or suboptimal vaccine-induced protection, pathogen adaptation, and improved case detection through expanded diagnostic capabilities. Addressing these challenges will require coordinated strategies to restore and optimize immunization delivery, strengthen surveillance and laboratory capacity (including resistance monitoring), and update clinical management guidance in the context of macrolide-resistant B. pertussis. Continued research is needed to define setting-specific drivers and to inform next-generation vaccines and integrated control strategies in the post-pandemic era.

The COVID-19 pandemic substantially altered pediatric respiratory infection patterns. This study assessed the impact of non-pharmaceutical interventions (NPIs) on upper respiratory bacterial epidemiology and microbiota composition in children under 2 years hospitalized with lower respiratory tract infections (LRTIs). Clinical data from 24,159 children admitted between January 2019 and December 2020 were retrospectively analyzed. Following NPI implementation, the overall culture-based bacterial detection rate declined from 61.02% to 18.38%. In an RSV-positive subgroup (pre-COVID-19, n = 95; COVID-19, n = 118), upper respiratory microbiota profiles were characterized using 16S rRNA gene sequencing. Alpha diversity increased significantly, while beta diversity showed distinct community separation between periods (Bray-Curtis distance, PERMANOVA P = 0.01). Taxonomic shifts included increased Proteobacteria and Actinobacteria and reduced Firmicutes, along with decreased Streptococcus and enrichment of Rothia, Dolosigranulum, and Corynebacterium. Overall, NPIs implemented during the COVID-19 pandemic were associated with marked alterations in the upper respiratory bacterial microbiota of RSV-positive young children, highlighting potential implications for future pediatric infection control strategies.

In this report evaluated a child was diagnosed with Talaromyces marneffei laryngitis with typical pictures.The classical laryngeal lesions caused by Talaromyces marneffei in our case are both educational and interesting.This report would help clinicians recognize laryngitis which caused by Talaromyces marneffei.

Since the implementation of coronavirus disease 2019 (COVID-19) restrictions since 2020, the number of Mycoplasma pneumoniae (M. pneumoniae) infections in children has significantly decreased. However, after the end of the COVID pandemic, there has been a notable resurgence in M. pneumoniae infections, which is particularly unusual in terms of both the number of infections and their severity. The purpose of this article is to review the existing evidence and explore theories that underlying the epidemiological shifts of M. pneumoniae following the COVID-19 pandemic, and propose factors contributing to the unconventional resurgence of M. pneumoniae infections. Proposed factors include decline of M. pneumoniae immunity, circulation of different genetic types and emergence of new macrolide-resistant M. pneumoniae (MRMP) variants, immune dysregulation following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and others. Among these factors, the decline in M. pneumoniae immunity and the circulation of different genetic types are considered significant contributors. Further research in bacterial genomics and more robust immunology studies are needed to guide the prevention of M. pneumoniae infections and the allocation of healthcare resources. International cooperation and information sharing are crucial for understanding the epidemiological changes of M. pneumoniae. Further cross-regional collaboration is called to enhance our understanding of the scope of M. pneumoniae outbreaks and facilitate a collective response.

Background:Pollen is a significant contributor to respiratory allergies worldwide, underscoring the importance of understanding its association with childhood sensitization to enhance clinical management. Objective:This study focuses on investigating the prevalence of various airborne pollens and their correlation with clinical characteristics of childhood respiratory allergic diseases in southeastern China. Methods:From November 2020 to October 2021, this research employed Durham monitoring samplers to collect airborne pollen. Simultaneously, skin prick tests (SPTs) were performed on children with respiratory allergic conditions at the Children's Hospital of Soochow University and standardised questionnaires are also administered to assess children's symptoms. Results:Over the course of November 2020 to October 2021, the study identified more than 36 pollen species. Notably, the spring season (March to May) exhibited the highest pollen concentrations, with Broussonetia accounting for 30.04% and Pinus for 26.38%. Similarly, the autumn months (September to October) saw prominent taxa like Humulus scandens (47.55%) and Gramineae (35.93%). Among the patients, a significant 92.7% exhibited positive reactions, with 81.7% showing sensitization to house dust mites (HMD), 17.8% to pollen, and 3.7% to Cockroach. Noteworthy the five most common pollens were observed for Bermuda (6.0%), Elm pollen (6.0%), Birch pollen (4.6%), and Mugwort (4.6%). The study indicated a substantial multisensitized ratio among pollen-sensitized patients in comparison to non-pollen-sensitized ones (97.4% vs 1.6%, P <0.001). Moreover, weekly total airborne pollen concentrations showed positive correlations with weekly admissions due to allergic rhinitis(AR)(r=0.642, P <0.001), bronchial asthma (BA) (r= 0.472, P<0.001), and the coexistence of AR and BA (r=0.485, P <0.001). Conclusion:The findings found that there were two peaks of pollen count in a year during March-May and September-October. The findings emphasize the critical role of specific airborne pollens in driving sensitization and exacerbating respiratory allergic diseases in children.

•Change of RSV-specific antibody concentrations among children of varying ages exhibited variability during the COVID-19 pandemic.•Among older children with notably reduced antibody concentrations, there was a significant increase in the number of RSV cases during the following RSV seasons.•Tracking shifts in antibody concentrations could help identify populations at risk of RSV infection.

BACKGROUND:The coronavirus disease 2019 (COVID-19) pandemic has caused significant changes in lower respiratory tract infections (LRTIs). This study aimed to characterize potentially pathogenic bacterial infections in paediatric patients hospitalized for LRTIs per-, during and post-COVID-19. METHODS:Sputum culture data from 85,659 children with LRTIs at the Children's Hospital of Soochow University from January 2016 to May 2024 were analyzed for eight bacteria: Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Moraxella catarrhalis, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii. The data during the pandemic (2020-2022, during COVID-19) and after the pandemic (January 2023-May 2024, post-COVID-19) were compared with those before the pandemic (2016-2019). RESULTS:Overall, 85,659 children with LRTIs were enrolled. Of these, 42,567 cases (49.7%) were diagnosed in the pre-COVID-19 period, 22,531 cases (26.3%) during the COVID-19 period and 20,561 cases (24.0%) in the post-COVID-19 period. The overall positive rate for pathogenic bacteria was 37.1%, with the top three being S. pneumoniae (14.5%), H. influenzae (12.1%) and S. aureus (6.5%). Compared to the average pre-COVID-19 levels, the bacterial pathogen positive rate decreased by 3.5% during the COVID-19 period (OR: 0.94, 95% CI: 0.91-0.98) and by 23.4% in the post-COVID-19 period (OR: 0.66, 95% CI: 0.64-0.69). During the COVID-19 period, the positive rates for S. pneumoniae, H. influenzae, E. coli, K. pneumoniae and mixed infections decreased by 11.7%, 35.3%, 22.2%, 33.3% and 45.7% respectively, while the positive rates for S. aureus, M. catarrhalis and P. aeruginosa increased by 21.7%, 44.7% and 25% respectively. In the post-COVID-19 period, the positive rates for S. pneumoniae, H. influenzae, E. coli, P. aeruginosa, K. pneumoniae, A. baumannii and mixed infections decreased by 50.0%, 7.4%, 22.2%, 50.0%, 44.4%, 60.0% and 32.6% respectively, while there was no statistical change in the positive rates for S. aureus and M. catarrhalis. Bacteria case detection decreases in 2020 (67.0%), 2021 (60.5%), 2022 (76.3%) and 2023 (72.7%) compared to predicted cases. CONCLUSIONS:Measures to restrict COVID-19 as a driver of declining bacterial positive rates. Respiratory bacteria in children are change across COVID-19 phases, age groups and seasons. After COVID-19, clinicians should continue to increase surveillance for pathogenic bacteria, especially drug-resistant flora.

BackgroundThe implementation of a zero-COVID policy for 3 years in China during the COVID-19 pandemic significantly impacted a broad spectrum of acute respiratory tract infections (ARTIs). The epidemiological characteristics of ARTI pathogens in children following the cessation of the zero-COVID policy remain unclear.MethodsEtiologically diagnostic data from 82,708 children with ARTIs at the Children’s Hospital of Soochow University during 2016–2023 were analyzed for 8 pathogens (human respiratory syncytial virus [HRSV], influenza A [FluA], FluB, human parainfluenza virus [HPIV], adenovirus [ADV], human rhinovirus [HRV], bocavirus [BoV], and mycoplasma pneumoniae [MP]). The changes in respiratory infections in Suzhou, China during the first year (2020, Phase I) and the second and third years of the pandemic (2021–2022, Phase II) and the first year after the end of zero-COVID policy (2023, Phase III) versus that in the pre-pandemic years (2016–2019) were compared.ResultsWhen compared with the average pre-pandemic levels, the pathogen-positive rate decreased by 19.27% in Phase I (OR: 0.70; 95% CI: 0.67–0.74), increased by 32.87% in Phase II (OR: 1.78; 95% CI: 1.72–1.84), and increased by 79.16% in Phase III (OR: 4.58; 95% CI: 4.37–4.79). In Phase I, the positive rates of HRSV, FluA, ADV, and MP decreased by 26.72, 58.97, 72.85, and 67.87%, respectively, and the positive rates of FluB, HPIV, HRV, and BoV increased by 86.84, 25, 32.37, and 16.94%, respectively. In Phase III, the positive rates of HRSV, FluA, FluB, HPIV, ADV, and HRV increased by 39.74, 1046.15, 118.42, 116.57, 131.13, and 146.40%, respectively, while the positive rate of BoV decreased by 56.12%. MP was inhibited during the epidemic, and MP showed a delayed outbreak after the ending of the zero-COVID policy. Compared with the average pre-pandemic levels, the MP-positive rate in Phase III increased by 116.7% (OR: 2.86; 95% CI: 2.74–2.99), with the highest increase in 0–1-year-old children.ConclusionThe strict and large-scale implementation of the zero-COVID policy in the early stages of the COVID-19 pandemic was the main driving factor for the sharp reduction in the rate of children’s respiratory pathogenic infections. The termination of this policy can cause a resurgence or escalation of pathogenic infections.

After ending the three-year zero COVID policy in China, the epidemiology of other respiratory pathogens has been affected. This study aimed to characterize of common respiratory pathogen infections in pediatric patients hospitalized for acute respiratory tract infections (ARTIs) in Suzhou before and after ending the zero COVID policy. Nasopharyngeal aspirates (NPAs) were obtained from children with ARTIs (aged <= 16 years) at the Children's Hospital of Soochow University for the detection of respiratory syncytial virus (RSV), influenza A (FluA), FluB, human parainfluenza virus (HPIV), adenovirus (ADV), human rhinovirus (HRV), bocavirus (BoV), human metapneumovirus (HMPV), and mycoplasma pneumoniae (MP). The data were compared between two periods: January 2020 to December 2022 (before ending the zero COVID policy) and January 2023 to May 2024 (after ending the zero COVID policy). Patients were divided into four groups: 0-2, >= 3-5, >= 6-10, and >= 11-16 years. A total of 42,379 patients were enrolled and the top four pathogens identified were MP, HRV, RSV and HPIV with positive rates of 20.2%, 19.5%, 15.1%, and 6.9%, respectively. A total of 28,352 positive cases were detected, with positive rates of 54.0% (n = 11,850/21,941) and 80.7% (n = 16,502/20,438) before and after ending the zero COVID policy, respectively. Total RSV, HRV, HPIV, and MP positivity increased by 27.8%, 39.0%, 12.3%, and 322.7%, respectively, after ending the zero COVID policy compared to positivity before the policy. After ending the zero COVID policy, the positive rates of RSV, HRV, and HPIV increased most in children aged 0-2 years, with increases by 88.8% (OR: 2.3, 95% CI: 2.2-2.5), 50.0% (OR: 1.6, 95% CI: 1.5-1.7), and 69.6% (OR: 1.8, 95% CI: 1.6-2.0), respectively. The greatest increase in MP positivity was 316.9% in the 3-5 years (OR: 5.5, 95% CI: 4.9-6.1). After ending the zero COVID policy, the RSV-positive rate increased most in summer, while HRV was predominantly circulated in spring and the MP-positive rate peaked in autumn. Ending the zero COVID policy facilitated the transmission of common respiratory pathogens in children. Post-pandemic surveillance and control of respiratory pathogens must be strengthened to reduce health risks.

Objective The objective of this study is to examine the risk factors associated with apnea in hospitalized patients diagnosed with bronchiolitis and to develop a nomogram prediction model for the early identification of patients who are at risk of developing apnea.Methods The clinical data of patients diagnosed with acute bronchiolitis and hospitalized at the Children's Hospital of Nanjing Medical University between February 2018 and May 2021 were retrospectively analyzed. LASSO regression and logistic regression analysis were used to determine the risk factors for apnea in these patients. A nomogram was constructed based on variables selected through multivariable logistic regression analysis. Receiver operating characteristic (ROC) curve and calibration curve were used to assess the accuracy and discriminative ability of the nomogram model, and decision curve analysis (DCA) was performed to evaluate the model's performance and clinical effectiveness.Results A retrospective analysis was conducted on 613 children hospitalized with bronchiolitis, among whom 53 (8.6%) experienced apnea. The results of Lasso regression and Logistic regression analyses showed that underlying diseases, feeding difficulties, tachypnea, WBC count, and lung consolidation were independent risk factors for apnea. A nomogram prediction model was constructed based on the five predictors mentioned above. After internal validation, the nomogram model demonstrated an AUC of 0.969 (95% CI 0.951-0.987), indicating strong predictive performance for apnea in bronchiolitis. Calibration curve analysis confirmed that the nomogram prediction model had good calibration, and the clinical decision curve analysis (DCA) indicated that the nomogram was clinically useful in estimating the net benefit to patients.Conclusion In this study, a nomogram model was developed to predict the risk of apnea in hospitalized children with bronchiolitis. The model showed good predictive performance and clinical applicability, allowing for timely identification and intensified monitoring and treatment of high-risk patients to improve overall clinical prognosis.

Objective: The aim of the study is to describe the season of RSV prevalence in China during the COVID-19 pandemic. Methods: This multicenter retrospective study analyzed the epidemiology of pediatric RSV infections and the possible factors contributing to its variations in China from January 1, 2019, to October 31, 2022. Results: A total of 872,565 children were included. During the pandemic, RSV detection rate increased across various regions, including South China, East China, Central China, and Northeast China. From 2019 to 2021, the detection rates of RSV showed an increasing trend among children aged <1 year, 1-2 years, and 3-5 years, but decreased in 2022. Among those tested positive for RSV, the proportion of children under 1 year old significantly decreased during the pandemic. The spring season of RSV in China in 2020 was shortened, and most regions experienced a summer season of RSV in 2021. This shift led to a year-round RSV outbreak throughout 2021. After April 2022, RSV positive rate significantly decreased, and no clear seasonal pattern was observed. Conclusion: Our study found that the COVID-19 pandemic has disrupted the seasonal pattern of RSV outbreaks in China, leading to increased RSV positive rate and off-season outbreaks.

ObjectiveThis study examines the epidemiology of Mycoplasma pneumoniae (M. pneumoniae) infections among children in Suzhou, China, during various pandemic phases. The goal is to discern evolving epidemic trends and to furnish robust evidence for clinical diagnosis and treatment.MethodsFrom January 1, 2016, to December 31, 2023, 113,625 consecutive patients with respiratory infections from three hospitals in Suzhou, China (Children’s Hospital of Soochow University, Children’s Hospital of Wujiang District, and Affiliated Suzhou Hospital of Nanjing University Medical School), were retrospectively enrolled in a surveillance study. Additionally, in 2023, children hospitalized with M. pneumoniae pneumonia at the Children’s Hospital of Soochow University were tested for genotype (P1 gene typing, SNP genotyping) and macrolide resistance in their bronchoalveolar lavage fluid.ResultsFrom 2016 to 2023, the M. pneumoniae positive detection rate among pediatric respiratory infections fell from a pre-pandemic 21.1% to pandemic lows, then surged to 45.3% post-pandemic. Before the pandemic, peak M. pneumoniae infection rates occurred in summer, followed by autumn. Post-pandemic, the highest peak rates were in autumn. Peak M. pneumoniae detection rates occurred in 2019 and 2023, with a notable increase in children aged 6 and older in 2023. In this study, 200 M. pneumoniae-positive bronchoalveolar lavage fluid (BALF) cases in 2023 were randomly selected and analyzed for P1 genotype and SNP genotype. Among 156 cases, 81.4% were P1 genotype and 18.6% were P2 genotype. The proportion of severe M. pneumoniae pneumonia with the P1 type was significantly higher than that with the P2 type (p < 0.05). Of the 192 samples analyzed, 11 SNP genotypes were identified, with SNP-27 predominating (36.5%), followed by SNP-0 (21.4%), SNP-11 (18.8%), and SNP-34 (17.7%). Of the 192 BALF specimens, 97.3% exhibited macrolide resistance mutations, with A2063G mutations at 96.17%. The mutation rates for the 23S rRNA 2064 and 2,617 were 1.6 and 1.0%, respectively.ConclusionPost-COVID-19 in Suzhou, China, M. pneumoniae infection patterns shifted significantly, with initial NPIs-induced declines followed by a sharp rise in cases, especially impacting school-age children. This trend underscores the importance of ongoing epidemiological surveillance and the development of strategic public health responses.

在T2介导的重症哮喘中,靶向T2细胞因子的生物制剂(如抗IL-5药物美泊利珠单抗)能显著减少哮喘急性发作率[1].美泊利单抗对重度哮喘患者的气道炎症抑制已经得到证实,但该生物疗法是否会影响气道微生物成分目前尚无定论[2].近期Diver等[3]研究了重度哮喘患者T2生物标志物与微生物谱之间的关系,并探讨了美泊利单抗对气道微生物生态的影响.

ObjectiveWe compared the clinical data of hospitalized children with lower respiratory tract infections caused by human bocavirus (HBoV) and human metapneumovirus (hMPV).MethodsIn total, 8,430 children admitted to the Department of Respiration, Children's Hospital of Soochow University for lower respiratory tract infections from January 2017 to October 2021 were enrolled. Seven common respiratory viruses, including respiratory syncytial virus, influenza virus A, influenza virus B, parainfluenza virus (PIV) I, PIV II, PIV III, and adenovirus, were detected by direct immunofluorescence assay, whereas human rhinovirus and hMPV were detected by reverse transcription-polymerase chain reaction. Mycoplasma pneumoniae (MP) and HBoV were detected by real-time fluorescence quantitative polymerase chain reaction. Bacteria was detected in blood, nasopharyngeal secretion, bronchoalveolar lavage specimen or pleural fluid by culture. In parallel, MP was detected by enzyme-linked immunosorbent assay. In addition, we performed metagenomic testing of alveolar lavage fluid from some of the patients in our study.ResultsThe detection rate of HBoV was 6.62% (558/8430), whereas that of hMPV was 2.24% (189/ 8430). The detection rate of HBoV was significantly higher in children aged 1 to <3 years than in other age groups, but there were no significant differences in positivity rates for hMPV by age. Before 2020, the incidence of HBoV infection peaked in summer and autumn, whereas that of hMPV peaked in spring. The epidemiology of both HBoV and hMPV has changed because of the impact of the novel coronavirus. Among the positive cases, the HBoV mixed infection rate was 51.6%, which was similar to that for hMPV mixed infection (44.4%). Comparing clinical characteristics between HBoV and hMPV single infection, the median age of children was 17 months in the HBoV group and 11 months in the hMPV group. In the HBoV single infection group, 31 patients (11.5%) had pulse oxygen saturation of less than 92% on admission, 47 (17.4%) had shortness of breath, and 26 (9.6%) presented with dyspnea. Meanwhile, four patients (3.8%) in the hMPV single infection group had pulse oxygen saturation of less than 92% on admission, eight (7.6%) displayed shortness of breath, and three (2.9%) had dyspnea. The proportion of patients requiring mechanical ventilation and the rate of PICU admission were higher in the HBoV group than in the hMPV group.ConclusionThe prevalence of HBoV infection is higher than that of hMPV infection in children with lower respiratory tract infection in Suzhou, and HBoV is more likely to cause severe infection than hMPV. Public health interventions for COVID-19 outbreaks have affected the prevalence of HBoV and hMPV.

呼吸道合胞病毒(Respiratory syncytial virus,RSV)感染每年导致320万名5岁以下儿童住院,11.8万人死亡[1].在澳大利亚,大多数地区在秋季和冬季经历季节性RSV爆发.为限制严重SARS-CoV-2传播而采取的非药物干预措施扰乱了许多国家常见呼吸道病原体的典型季节性.这些限制措施也抑制了季节性呼吸道病毒的传播,特别是流感病毒和RSV[2].Eden等[3]报道了随着SARS-CoV-2的出现,澳大利亚RSV流行病学出现了重大转变,且在2020年至2021年夏季发生了反季节的大规模暴发,该研究还对引起这一大规模爆发的RSV进行了宏基因组测序.

BACKGROUND: Human rhinovirus (hRV) is a critical viral pathogen implicated in bronchiolitis in children. However, there is no study on hRV bronchiolitis in children from Southeast China. The aim of this study was to determine the incidence and clinical features of hRV bronchiolitis in Southeast China.METHODS: The study was carried out in Children’s Hospital of Soochow University on children admitted with the diagnosis of bronchiolitis from January 2013 to December 2014. hRV was tested using reverse-transcription polymerase chain reaction.RESULTS: hRV was identified in 140 of 797 specimens (17.6%). hRV was detected with a highest rate in June and August. The hRV positive rate in patients younger than 6 months of age was significantly lower than that in other age groups (P<0.01). The most common radiological finding was hyperinflation (51.4%). Patients with hRV infection were older and more likely to have eczema than those with RSV.CONCLUSIONS: The hRV was an important viral pathogen associated with bronchiolitis in children with an epidemic peak in summer. Most of patients were between 6 to 24 months and with a high presence of eczema.