Changes in the pathogenic characteristics of hospitalized children with community-acquired pneumonia in Changzhou, China, 2018–2023
5 affiliations
- 1Department of Epidemiology, Key Laboratory of Public Health Safety and Emergency Prevention and Control Technology of Higher Education Institutions in Jiangsu Province, Center for Global Health, School of Public Health, Nanjing Medical University
- 2Department of Nursing, Changzhou Hygiene Vocational Technology College
- 3Affiliated Changzhou Children’s Hospital of Nantong University
- 4Changzhou Center for Disease Control and Prevention
- 5Department of Epidemiology, School of Public Health, Fudan University
Abstract
Background Community-acquired pneumonia (CAP) is a significant cause of hospitalization and mortality in children. Non-pharmacological interventions (NPIs) implemented during the COVID-19 pandemic were associated with changes in the transmission dynamics of respiratory pathogens. The present study aimed to analyze changes in the pathogenic characteristics of hospitalized children with CAP in a single-center pediatric cohort in Changzhou, China, before and after the outbreak of COVID-19. Methods We retrospectively reviewed demographic information, hospitalization records, and pathogen-detection results of children admitted for CAP at Changzhou Children’s Hospital, Jiangsu Province, China, from 2018 to 2023. The analyzed pathogens included eight target bacteria and seven respiratory viruses. Results A total of 29,552 children hospitalized with CAP were included, including 15,124 in the pre-pandemic period, 9024 in the pandemic period, and 5404 in the post-pandemic period. The male-to-female ratio was 1.42:1, and the median age was 16 months (IQR: 5.0–37.0). Hospitalizations generally peaked in autumn and winter from 2018 to 2022, whereas an off-season peak occurred in May 2023. The overall bacterial positivity increased from 9.94% before the pandemic to 13.96% during the pandemic and 13.68% after the pandemic, while viral positivity increased from 16.52% to 21.43% and 21.06%, respectively. In contrast, coinfection positivity decreased from 6.89% before the pandemic to 5.13% during the pandemic and 3.02% after the pandemic. Across all three periods, Escherichia coli consistently ranked first among bacterial detections, while RSV remained the predominant virus among viral detections. Conclusions Noticeable shifts in the detection spectrum and positivity rates of common bacterial and viral pathogens were observed among hospitalized children with CAP following the implementation and relaxation of COVID-19 prevention and control policies. Continuous long-term surveillance is needed to refine targeted prevention strategies and optimize clinical treatment protocols for pediatric CAP. Clinical trial Not applicable.
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BibTeX
@article{hu2026changes,
title = {{Changes in the pathogenic characteristics of hospitalized children with community-acquired pneumonia in Changzhou, China, 2018–2023}},
author = {Feifei Hu and Keyi Ji and Meng Gu and Fang Yao and Tao Zhang and Qiuwei Wang and Maryam Zaid and Yunzhi Ling and Xiaoting Wu and Genming Zhao and Jianming Wang},
journal = {BMC Infectious Diseases},
year = {2026},
month = jul,
doi = {10.1186/s12879-026-14024-9},
url = {https://doi.org/10.1186/s12879-026-14024-9},
note = {CC BY},
}
RIS
TY - JOUR
TI - Changes in the pathogenic characteristics of hospitalized children with community-acquired pneumonia in Changzhou, China, 2018–2023
AU - Feifei Hu
AU - Keyi Ji
AU - Meng Gu
AU - Fang Yao
AU - Tao Zhang
AU - Qiuwei Wang
AU - Maryam Zaid
AU - Yunzhi Ling
AU - Xiaoting Wu
AU - Genming Zhao
AU - Jianming Wang
PY - 2026
DA - 2026/07/01
JO - BMC Infectious Diseases
DO - 10.1186/s12879-026-14024-9
UR - https://doi.org/10.1186/s12879-026-14024-9
AB - Background Community-acquired pneumonia (CAP) is a significant cause of hospitalization and mortality in children. Non-pharmacological interventions (NPIs) implemented during the COVID-19 pandemic were associated with changes in the transmission dynamics of respiratory pathogens. The present study aimed to analyze changes in the pathogenic characteristics of hospitalized children with CAP in a single-center pediatric cohort in Changzhou, China, before and after the outbreak of COVID-19. Methods We retrospectively reviewed demographic information, hospitalization records, and pathogen-detection results of children admitted for CAP at Changzhou Children’s Hospital, Jiangsu Province, China, from 2018 to 2023. The analyzed pathogens included eight target bacteria and seven respiratory viruses. Results A total of 29,552 children hospitalized with CAP were included, including 15,124 in the pre-pandemic period, 9024 in the pandemic period, and 5404 in the post-pandemic period. The male-to-female ratio was 1.42:1, and the median age was 16 months (IQR: 5.0–37.0). Hospitalizations generally peaked in autumn and winter from 2018 to 2022, whereas an off-season peak occurred in May 2023. The overall bacterial positivity increased from 9.94% before the pandemic to 13.96% during the pandemic and 13.68% after the pandemic, while viral positivity increased from 16.52% to 21.43% and 21.06%, respectively. In contrast, coinfection positivity decreased from 6.89% before the pandemic to 5.13% during the pandemic and 3.02% after the pandemic. Across all three periods, Escherichia coli consistently ranked first among bacterial detections, while RSV remained the predominant virus among viral detections. Conclusions Noticeable shifts in the detection spectrum and positivity rates of common bacterial and viral pathogens were observed among hospitalized children with CAP following the implementation and relaxation of COVID-19 prevention and control policies. Continuous long-term surveillance is needed to refine targeted prevention strategies and optimize clinical treatment protocols for pediatric CAP. Clinical trial Not applicable.
SN - 1471-2334
ER -