This study analyzed the epidemiological characteristics and trends of respiratory syncytial virus (RSV) infections among inpatients with acute respiratory infections (ARI) in a children's hospital in Shenzhen City inpatients from 2020 to 2023. From January 2020 to December 2023, multiple reverse transcription polymerase chain reaction (RT-PCR) combined with capillary electrophoresis fragment analysis technology was used to detect the nucleic acids of 12 respiratory pathogens, including RSV, in hospitalized children diagnosed with ARI. The patients were divided into six age groups: 0 to <6 months, 6 months to <1 year, 1 to <2 years, 2 to <5 years, 5 to <10 years, and 10 to <18 years. A total of 53 033 children were tested, including 6 830 RSV positive cases, with an overall positivity rate of 12.88%. The annual RSV positivity rates from 2020 to 2023 were 20.04%, 16.18%, 4.89%, and 13.33%, respectively, with statistically significant differences between the years (χ²=1 185.994, P<0.001). The positive rate of RSV detection decreased with increasing age across all years (all P trend<0.05). From 2020 to 2023, the proportion of RSV-positive cases aged 2 to 5 years and older showed an increasing trend (P trend<0.001 for all years). Compared to 2023, the median age of RSV-infected children was lower in 2020 (Z=7.826, P<0.001) and 2021 (Z=6.106, P<0.001). The proportion of severe infections requiring ICU admission did not change significantly across all years (χ²=0.179, P=0.981). The RSV epidemic season in 2020 mainly occurred during 28-43 weeks, and in 2021, it spanned from 22-43 weeks. However, in 2022, the season was delayed until the 49th week and lasted for three weeks. In 2023, the seasonal epidemic appeared earlier, starting in the 14th week and lasting for 28 weeks. From 2020 to 2023, the rate of RSV co-infections with other pathogens (mycoplasma pneumoniae, human parainfluenza virus, human bocavirus, human coronavirus, human metapneumovirus, and influenza A) significantly increased (all P trend<0.01). In conclusion, the epidemiological characteristics of RSV infections in Shenzhen Children's Hospital changed from 2020 to 2023. In 2022, there were only delayed, low-intensity and short-lived seasonal epidemics. However, in 2023, there was an earlier and prolonged epidemic, with increased infections in children aged 2 to 5 years and older and a rise in co-infections, while the proportion of severe infections requiring ICU admission remained unchanged.
分析 2020—2023 年深圳市儿童医院急性呼吸道感染（ARI）住院患者中呼吸道合胞病毒（RSV）感染的流行特征及变化趋势。于 2020 年 1 月至 2023 年 12 月，采用多重逆转录聚合酶链反应联合毛细电泳片段分析技术对确诊为ARI且住院的患者进行RSV等12种呼吸道病原的核酸检测。将患者分为6 个年龄组：0~<6 个月、6个月~<1 岁、1~<2 岁、2~<5 岁、5~<10 岁、10~<18 岁。共检测患者 53 033 例，其中RSV阳性病例 6 830 例，总阳性率为 12.88%。2020—2023 年RSV阳性率分别为 20.04%、16.18%、4.89%和 13.33%，各年度间差异有统计学意义（χ²=1 185.994，P<0.001）。各年度RSV检测阳性率随年龄增长而呈降低趋势（均P趋势<0.05）。2020—2023 年，2~<5 岁及以上年龄组患者比例呈上升趋势（均P趋势<0.001）；与2023年比较，2020年（Z=7.826，P<0.001）、2021年（Z=6.106，P<0.001）RSV感染患者年龄较低。各年度需住ICU的重症感染比例无显著变化（χ²=0.179，P=0.981）。RSV流行季节在2020年主要为第28~43周；在2021年为第22~43周；2022 年推迟至第49周开始季节性流行，持续3周；2023 年第14周提前出现季节性流行，并持续了28周。2020—2023 年RSV混合其他病原体（肺炎支原体、人副流感病毒、人博卡病毒、人冠状病毒、人偏肺病毒、甲型流感病毒）感染率显著上升（均P趋势<0.010）。综上，2020—2023年本研究的儿童医院RSV感染流行特征发生变化，2022年只出现了推迟、低强度和短暂的季节性流行；而2023年提前出现季节性流行并且持续时间长，2~5 岁及以上儿童感染增多，混合感染增多，但需住ICU重症感染比例无变化。.