AI Insight
This study examined respiratory infections in 101 hospitalized adults with severe acute respiratory infections in northern Thailand from November 2023 to April 2024. Using multiplex PCR testing, researchers found that 47% of patients tested positive for at least one respiratory pathogen, with adenovirus (17%) and rhinovirus (13%) being most common, while 9% had co-infections. The findings reveal post-pandemic circulation patterns of respiratory viruses in tropical regions, with seasonal peaks for influenza A and rhinovirus in January and consistent circulation of adenovirus and enterovirus throughout the study period.
Why it matters
This surveillance data helps clinicians and public health officials understand which respiratory pathogens are circulating in Southeast Asia after COVID-19 disrupted normal patterns. The high rate of empiric antibiotic use despite viral etiology underscores the need for rapid diagnostic testing to improve treatment decisions and antimicrobial stewardship in hospital settings.
by Nang Kham-Kjing, Rathakarn Kawila, Patcharaporn Tariyo, Kittiyaporn Puapun, Sirinat Wongchotbrorirak, Nicole Ngo-Giang-Huong, Sayamon Hongjaisee, Woottichai Khamduang
Introduction
The COVID-19 pandemic disrupted the circulation patterns of respiratory viruses. In tropical regions like Thailand, ongoing surveillance is essential to understand the etiology of severe acute respiratory infections (SARIs) in the post-pandemic era. We investigated the etiology of SARI among hospitalized adults in the post-pandemic era.
Methods
We conducted a retrospective analysis of respiratory samples collected from adult patients (≥18 years) who were hospitalized at a regional hospital in Chiang Mai, Thailand, between November 2023 and April 2024 due to symptoms of SARI (fever of ≥38°C, cough, and onset within 10 days). Sputum and/or nasopharyngeal swab were collected at admission and tested using a multiplex real-time PCR assay targeting 22 respiratory viruses and Mycoplasma pneumoniae (Siemens Healthineers Fast Track Diagnostics and Tellgen SARS-CoV-2 Nucleic Acid Detection Kit). Demographic, clinical, treatment, and comorbidity data were extracted from hospital records, and descriptive statistics were used to summarize patient characteristics and pathogen distribution.
Results
Among 101 hospitalized SARI patients (median age 62 years (interquartile range 43–71); 57 males), 47 (47%) tested positive for at least one respiratory pathogen. The most frequently detected viruses were adenovirus (17/101, 17%) and rhinovirus (13/101, 13%). Co-infections occurred in 9% (9/101) of cases. Seasonal trends showed peaks of influenza A and rhinovirus in January, while adenovirus and enterovirus circulated consistently throughout the study period.
Conclusions
Nearly half of adult SARI cases were associated with viral pathogens. Other SARI etiologies could be due to bacterial or fungal infections not tested in our study. The high rate of empiric antibiotic use highlights the need for broader and rapid molecular diagnostics. Enhanced pathogen-specific surveillance is essential to guide evidence-based clinical management in the post-pandemic context.