OBJECTIVE  To analyze the epidemiological characteristics of common respiratory pathogens in respiratory infection patients in Weihai City, and to provide an epidemiological basis for formulating precise regional prevention and control strategies.

METHODS  We collected the data of 14 respiratory pathogens test in respiratory infection patients from the same period in Weihai. The positive rate, positive cases, and composition ratio of pathogens were calculated. The distribution characteristics of pathogens were analyzed in terms of year, sex, age, season and different SARS-CoV-2 prevention and control phases.

RESULTS  A total of 42 353 test results were included, with an overall positive rate of 11.90% （5 038/42 353）. The top five pathogens in terms of positive counts were Mycoplasma pneumoniae, SARS-CoV-2, influenza A virus, respiratory syncytial virus and adenovirus. During the SARS-CoV-2 prevention and control period （2021－2022）, pathogen detection levels were relatively low. After the routine epidemic management period （2023－2024）, the detection spectrum of respiratory pathogens rebounded and tended to diversify, with a slight decline in overall positive cases in 2024 compared to the previous year. In terms of age distribution, respiratory syncytial virus and M. pneumoniae were predominant in infants and young children, while M. pneumoniae was the main pathogen in school-aged children. Influenza virus and SARS-CoV-2 were more common in adults and the elderly. Seasonally, influenza A virus and respiratory syncytial virus dominated in spring, SARS-CoV-2 detection was relatively high in summer, M. pneumoniae peaked in autumn, and winter exhibited a co-circulation of multiple pathogens. M. pneumoniae maintained a high detection level throughout the study period.

CONCLUSIONS  The epidemiological characteristics of respiratory pathogens in Weihai from 2021 to 2024 fluctuated with prevention and control phases, showing significant variations across age groups and seasons. M. pneumoniae remains the dominant pathogen during the study period. This highlights the need to further improve a cross-institutional collaborative surveillance system for regional respiratory pathogens and develop targeted prevention and control measures based on population-specific and seasonal epidemiological features.