有症状门诊患者的混合呼吸道感染：社区卫生机构的一项研究

IF 1.8 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease Pub Date : 2025-08-20 DOI:10.1016/j.diagmicrobio.2025.117074

Jiaman Liao , Xueliang Huang , Hao Huang , Cuina Shen , Jing Li , Haiting Zhai , Yiqiang Zhan , Lingwei Wang

{"title":"有症状门诊患者的混合呼吸道感染：社区卫生机构的一项研究","authors":"Jiaman Liao , Xueliang Huang , Hao Huang , Cuina Shen , Jing Li , Haiting Zhai , Yiqiang Zhan , Lingwei Wang","doi":"10.1016/j.diagmicrobio.2025.117074","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Mixed respiratory infections in individuals with respiratory symptoms in primary care settings are understudied. This study aims to investigate their epidemiology and determinants.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with 244 consecutive adult patients with respiratory symptoms at Nanlian Community Health Center (January–March 2024). Throat swabs were analyzed for 18 respiratory pathogens and SARS-CoV-2 using multiplex PCR. Hematological parameters, including neutrophil-to-lymphocyte ratio (NLR), were measured from blood counts. The primary outcome was infection status (uninfected, single, or mixed). Multinomial logistic regression models identified factors associated with infection patterns.</div></div><div><h3>Results</h3><div>The initial cohort included 294 patients and 5,292 pathogen test results, with 319 (6.0 %) positive for at least one of 18 targeted pathogens. The most common pathogens in mixed infections were Influenza A Virus (25.1 %), H3N2 (23.5 %), and Haemophilus influenzae (22.3 %). After excluding 50 cases with incomplete questionnaires, the analytical cohort consisted of 244 participants (83.0 % of total), 56.1 % of whom were female. The largest age group was 19–40 years (71.3 %), and 65 participants (26.6 %) had mixed infections. Higher symptom counts (adjusted OR=1.700, 95 % CI 1.346–2.147) and elevated NLR (adjusted OR=1.232, 95 % CI 1.068–1.422) were linked to mixed infections. SARS-CoV-2 co-infection was negatively associated with mixed infections (adjusted OR=0.141, 95 % CI 0.035–0.575).</div></div><div><h3>Conclusions</h3><div>Mixed infections correlate with greater symptom burden and higher inflammation markers. The inverse relationship with SARS-CoV-2 warrants further investigation. Findings support targeted pathogen testing in symptomatic patients with elevated NLR.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"114 1","pages":"Article 117074"},"PeriodicalIF":1.8000,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Mixed respiratory infections in symptomatic outpatients: A study in community health settings\",\"authors\":\"Jiaman Liao , Xueliang Huang , Hao Huang , Cuina Shen , Jing Li , Haiting Zhai , Yiqiang Zhan , Lingwei Wang\",\"doi\":\"10.1016/j.diagmicrobio.2025.117074\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Mixed respiratory infections in individuals with respiratory symptoms in primary care settings are understudied. This study aims to investigate their epidemiology and determinants.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with 244 consecutive adult patients with respiratory symptoms at Nanlian Community Health Center (January–March 2024). Throat swabs were analyzed for 18 respiratory pathogens and SARS-CoV-2 using multiplex PCR. Hematological parameters, including neutrophil-to-lymphocyte ratio (NLR), were measured from blood counts. The primary outcome was infection status (uninfected, single, or mixed). Multinomial logistic regression models identified factors associated with infection patterns.</div></div><div><h3>Results</h3><div>The initial cohort included 294 patients and 5,292 pathogen test results, with 319 (6.0 %) positive for at least one of 18 targeted pathogens. The most common pathogens in mixed infections were Influenza A Virus (25.1 %), H3N2 (23.5 %), and Haemophilus influenzae (22.3 %). After excluding 50 cases with incomplete questionnaires, the analytical cohort consisted of 244 participants (83.0 % of total), 56.1 % of whom were female. The largest age group was 19–40 years (71.3 %), and 65 participants (26.6 %) had mixed infections. Higher symptom counts (adjusted OR=1.700, 95 % CI 1.346–2.147) and elevated NLR (adjusted OR=1.232, 95 % CI 1.068–1.422) were linked to mixed infections. SARS-CoV-2 co-infection was negatively associated with mixed infections (adjusted OR=0.141, 95 % CI 0.035–0.575).</div></div><div><h3>Conclusions</h3><div>Mixed infections correlate with greater symptom burden and higher inflammation markers. The inverse relationship with SARS-CoV-2 warrants further investigation. Findings support targeted pathogen testing in symptomatic patients with elevated NLR.</div></div>\",\"PeriodicalId\":11329,\"journal\":{\"name\":\"Diagnostic microbiology and infectious disease\",\"volume\":\"114 1\",\"pages\":\"Article 117074\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-08-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diagnostic microbiology and infectious disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0732889325003979\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diagnostic microbiology and infectious disease","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0732889325003979","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

摘要

背景：在初级保健机构中有呼吸道症状个体的混合性呼吸道感染的研究尚不充分。本研究旨在调查其流行病学和决定因素。方法对2024年1 - 3月在南联社区卫生中心连续就诊的244例有呼吸道症状的成年患者进行横断面研究。采用多重PCR方法分析咽喉拭子中18种呼吸道病原体和SARS-CoV-2。血液学参数，包括中性粒细胞与淋巴细胞比值（NLR），由血细胞计数测量。主要结局是感染状态（未感染、单一或混合）。多项逻辑回归模型确定了与感染模式相关的因素。结果初始队列包括294例患者，5292例病原体检测结果，其中319例（6.0%）对18种目标病原体中的至少一种呈阳性。混合感染中最常见的病原体是甲型流感病毒（25.1%）、H3N2（23.5%）和流感嗜血杆菌（22.3%）。在排除50例问卷不完整的病例后，分析队列包括244名参与者（占总数的83.0%），其中56.1%为女性。最大的年龄组是19-40岁（71.3%），65名参与者（26.6%）患有混合感染。较高的症状计数（调整后的OR=1.700, 95% CI 1.346-2.147）和升高的NLR（调整后的OR=1.232, 95% CI 1.068-1.422）与混合感染有关。SARS-CoV-2合并感染与混合感染呈负相关（校正OR=0.141, 95% CI 0.035-0.575）。结论混合性感染患者症状负担加重，炎症指标升高。与SARS-CoV-2的负相关关系有待进一步研究。研究结果支持对NLR升高的有症状患者进行靶向病原体检测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Mixed respiratory infections in symptomatic outpatients: A study in community health settings

Background

Mixed respiratory infections in individuals with respiratory symptoms in primary care settings are understudied. This study aims to investigate their epidemiology and determinants.

Methods

A cross-sectional study was conducted with 244 consecutive adult patients with respiratory symptoms at Nanlian Community Health Center (January–March 2024). Throat swabs were analyzed for 18 respiratory pathogens and SARS-CoV-2 using multiplex PCR. Hematological parameters, including neutrophil-to-lymphocyte ratio (NLR), were measured from blood counts. The primary outcome was infection status (uninfected, single, or mixed). Multinomial logistic regression models identified factors associated with infection patterns.

Results

The initial cohort included 294 patients and 5,292 pathogen test results, with 319 (6.0 %) positive for at least one of 18 targeted pathogens. The most common pathogens in mixed infections were Influenza A Virus (25.1 %), H3N2 (23.5 %), and Haemophilus influenzae (22.3 %). After excluding 50 cases with incomplete questionnaires, the analytical cohort consisted of 244 participants (83.0 % of total), 56.1 % of whom were female. The largest age group was 19–40 years (71.3 %), and 65 participants (26.6 %) had mixed infections. Higher symptom counts (adjusted OR=1.700, 95 % CI 1.346–2.147) and elevated NLR (adjusted OR=1.232, 95 % CI 1.068–1.422) were linked to mixed infections. SARS-CoV-2 co-infection was negatively associated with mixed infections (adjusted OR=0.141, 95 % CI 0.035–0.575).

Conclusions

Mixed infections correlate with greater symptom burden and higher inflammation markers. The inverse relationship with SARS-CoV-2 warrants further investigation. Findings support targeted pathogen testing in symptomatic patients with elevated NLR.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Diagnostic microbiology and infectious disease 医学-传染病学

CiteScore

5.30

自引率

3.40%

发文量

149

审稿时长

56 days

期刊介绍： Diagnostic Microbiology and Infectious Disease keeps you informed of the latest developments in clinical microbiology and the diagnosis and treatment of infectious diseases. Packed with rigorously peer-reviewed articles and studies in bacteriology, immunology, immunoserology, infectious diseases, mycology, parasitology, and virology, the journal examines new procedures, unusual cases, controversial issues, and important new literature. Diagnostic Microbiology and Infectious Disease distinguished independent editorial board, consisting of experts from many medical specialties, ensures you extensive and authoritative coverage.