目的 分析海南省儿童急性呼吸道感染（acute respiratory tract infections，ARTI）常见呼吸道病原体的流行病学特征，为预防和诊治儿童ARTI提供参考。方法 选择2012年3月—2021年12月在海南省多家医院儿科住院治疗的ARTI患儿，采用间接免疫荧光法检测患儿血清甲型流感病毒(FluA)、乙型流感病(FluB)、呼吸道合胞病毒(RSV)、腺病毒（ADV)、副流感病毒(PIV)、肺炎支原体(Mp)、肺炎衣原体(Cp)、嗜肺军团菌(Lp)、Q热立克次体（COX）9种病原体的IgM抗体，某种病原体IgM抗体阳性定义为该种病原体感染，对呼吸道感染病例的流行病学和临床资料进行回顾性分析。结果 本研究符合入选条件患儿共59 312例，IgM阳性患儿检出率为37.69%（22 357/59312）。FluA、FluB、RSV、ADV、PIV的IgM阳性占总阳性率的35.23%（9 953/28255）；前3位病原体Mp、FluB、PIV阳性占IgM总阳性率86.54% (24 451/28255)，其检出率分别为28.58%（16 953/59312）、9.50%（5 636/59312）、3.14%（1 862/59312）。4 039例检出双重病原体，最常见的组合为Mp+FluB。各季节间比较，FluA、FluB、ADV、Cp和Lp在春季检出率最高，在秋季检出率最低；PIV、Mp和COX在夏季检出率最高，在冬季检出率最低。RSV在夏季检出率最高，在秋季检出率最低。2012—2021年期间2013年IgM阳性检出率最高（78.65%），2021年最低（15.72%），10年间各年检出率差异有统计学意义（P<0.001）。结论 海南地区呼吸道病原体的流行各有其季节性，可以针对其流行特征制订相应的防护措施，应对儿童高发季节的呼吸道病原体感染。

Objective To analyze the epidemiological characteristics of common respiratory tract pathogens in children with acute respiratory tract infections (ARTI) in Hainan Province, and to provide reference for the prevention, diagnosis and treatment of ARTI in children. Methods The children with ARTI who were hospitalized in several hospitals in Hainan Province from March 2012 to December 2021 were selected. The serum IgM antibody levels of influenza virus A (FluA), influenza virus B (FluB), respiratory syncytial virus (RSV), adenovirus (ADV), parainfluenza virus (PIV), Mycoplasma pneumoniae (Mp), Chlamydia pneumoniae (Cp), Legionella pneumophila (Lp) and Q fever Rickettsia (COX) were detected by indirect immunofluorescence method. An infection with a pathogen was characterized as having an IgM antibody positive for it. The epidemiological and clinical data of respiratory tract infection cases were analyzed retrospectively. Results In this study, a total of 59312 children were eligible for inclusion, and the IgM positive detection rate of respiratory pathogens was 37.69% (22357/59312). Among the 22 357 IgM positive children, 28255 IgM positive times were found, of them, 35.23% were IgM positive rate for FluA, FluB, RSV, ADV and PIV (9953/28255). The top 3 pathogens were Mp, FluB and PIV, accounting for 86.54% (24451/28255), and the IgM positive rate was 28.58% (16953/59312), 9.50% (5636/59312) and 3.14% (1862/59312), respectively. Dual pathogens were detected in 4039 cases, and the most common combination was Mp and FluB. The detection rates of FluA, FluB, ADV, Cp and Lp were the highest in spring and the lowest in autumn. The detection rates of PIV, Mp and COX were the highest in summer and the lowest in winter. The detection rate of RSV was the highest in summer and the lowest in autumn. The positive detection rate of respiratory pathogen IgM varied between 2012 and 2021, with the highest being in 2013 (78.65%) and the lowest being in 2021 (15.72%). The differences between the years were statistically significant (P<0.001). Conclusions The prevalence of various respiratory pathogens in Hainan region has its seasonality. The corresponding protective measures can be formulated according to their epidemic characteristics to deal with the respiratory infection during the peak incidence season for children.