Respiratory tract infections are prevalent. Which pathogens are causing the problem? One article will tell you all!

What is a respiratory infection? Is it the same as a cold?

Many people think that respiratory tract infection is what we often call a cold, but this view is actually incorrect. Respiratory tract infection is an infectious inflammation of the nose, pharynx, larynx, trachea, bronchi and lungs. It is divided into upper respiratory tract infection and lower respiratory tract infection based on the larynx. The main symptoms are fever, cough, sputum, dyspnea, etc., and a cold is the most common type of respiratory tract infection.

Which pathogenic microorganisms are responsible for respiratory infections?

Respiratory infections can be caused by viruses, bacteria, fungi and atypical pathogens. According to data released by the National Health Commission, influenza is the main respiratory infectious disease in recent years. In addition, there are rhinovirus, mycoplasma pneumoniae, respiratory syncytial virus, adenovirus and so on.

Respiratory infections caused by different pathogens have different characteristics. How can we identify them so that we can prevent and treat them correctly? The following chart can make it clear for us.

< One picture to understand >

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What are the effective medical detection methods for different pathogens?

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The commonly used detection methods in laboratories for the above-mentioned pathogens include antigen detection , antibody detection and nucleic acid detection .

Antigen tests are fast , and there are some commercially available products. If you are testing at home, you need to pay attention to the product anti-counterfeiting label, strictly follow the instructions, and use standard sampling. This method has low sensitivity and is prone to missed detection.

Antibody testing is affected by the time when the body produces antibodies and the body's immune function, and requires the collection of two samples of serum from the acute phase and the recovery phase for testing and result judgment. The sensitivity and specificity are both low, so it is not used as the main method for respiratory pathogen detection in clinical practice.

Nucleic acid testing has high sensitivity and specificity and is the gold standard for virus detection. Rapid nucleic acid testing and multiple nucleic acid testing (which can simultaneously detect 3 to 6 pathogens) are increasingly used in clinical practice and are recommended as the preferred detection methods in laboratories.

What should we do when the above routine testing methods cannot identify the pathogen of patients with respiratory infections and their condition tends to worsen?

It is recommended to use high-throughput sequencing methods to identify pathogens. This method can detect various pathogens contained in the specimen, but it is highly complex and requires vigilance against the possibility of contamination and colonization. Professional laboratory personnel and clinicians are needed to interpret the results.

↓ Consensus Recommendation↓

Expert consensus on the clinical application of nucleic acid detection technology for the diagnosis of pathogens of respiratory tract infections in adults (2023)

How should we respond to the high incidence of respiratory infections?

During the peak season for respiratory diseases, various pathogens appear alternately. When you or your family members develop symptoms of respiratory infection, you should consider your own health status and the severity of your symptoms.

→→ If the patient is a healthy adult and the clinical manifestations are mild symptoms such as nasal congestion, runny nose, sore throat, and low fever, he or she can recover quickly through symptomatic treatment, adequate rest, and proper nutrition;

→→ If the patient is an infant, elderly patient or pregnant woman , especially those with low immunity (such as cancer patients, autoimmune disease patients, etc.), and the clinical manifestations are high fever, difficulty breathing, impaired consciousness, etc., they should actively seek medical help. If conditions permit, antigen or nucleic acid testing for respiratory pathogens can be performed to identify the pathogen, so as to provide targeted anti-infection treatment. Avoid blind medication.

Commonly used medication guide

For influenza virus infected people, it is recommended that antiviral drugs be used as early as possible for the best effect . Antiviral treatment within 48 hours of onset can reduce complications, lower mortality, and shorten hospitalization time; severe patients with onset of more than 48 hours can still benefit from antiviral drugs. Commonly used anti-influenza virus drugs include oseltamivir , mabaloxavir , zanamivir , etc., but it should be noted that different drugs are suitable for different patient groups, especially for those who take other drugs at the same time due to underlying diseases. The above drugs must be used under the guidance of a doctor to avoid serious adverse drug reactions. In addition, the use of antipyretic, cough suppressant and other relief drugs is equally important.

There is currently no effective targeted antiviral drug for rhinovirus, adenovirus and respiratory syncytial virus infections . Treatment is mainly symptomatic, supplemented by rest and nutritional support. The symptoms of most patients can improve or be significantly alleviated within 1 week.

The first choice of drugs for mycoplasma infection is macrolide antibiotics, such as azithromycin and erythromycin. As prescription drugs, they should be used in a standardized manner with sufficient dosage and sufficient course of treatment under the guidance of a physician or pharmacist. Due to the increasing resistance rate of macrolide antibiotics, it is possible that symptoms will not improve significantly. In this case, a follow-up visit should be made in a timely manner to determine whether other types of antibiotics need to be replaced.

It should be noted that commonly used antibiotics such as azithromycin and cephalosporin are ineffective against viral infections and are not recommended for preventive use. Misuse or abuse of drugs may cause many adverse reactions.

Peking Union Medical College Medical Tips

The most effective and economical way to prevent infectious diseases is vaccination , which can effectively reduce the risk of infection, disease and severe illness. In addition, taking scientific preventive measures in daily life can also reduce the risk of infection and transmission.

First of all, a healthy lifestyle is an important guarantee for enhancing physical fitness and improving body resistance. It is necessary to ensure adequate sleep, nutrition and proper physical exercise.

Secondly, develop good personal hygiene habits , such as covering your mouth and nose with a tissue, towel or elbow when coughing or sneezing, and pay attention to hand hygiene and wash your hands frequently.

Third, keep the home and workplace environment clean , open windows regularly for indoor ventilation, and family members should wear masks when caring for patients with respiratory infections.

Finally, susceptible groups such as the elderly, children, pregnant women, and patients with chronic diseases should try to avoid crowded public places . If they must go, it is recommended that they wear masks and replace them in time.

<Recommended reading> [Hot words] Respiratory syncytial virus

Editor: Liu Yang and Zhao Na

Proofreading: Li Na, Li Yule, Dong Zhe, Li Huiwen

Producer: Wu Wenming

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