[Analysis of the respiratory pathogen test during the winter and spring of 2023-2024 in multiple locations of China with direct-to-consumer testing and the epidemiological characteristics of respiratory syncytial virus].

<b>Objective:</b> To investigate the detection status of respiratory pathogens with direct-to-consumer testing and the characteristics of the population with human respiratory syncytial virus (HRSV) detection in the winter and spring of 2023-2024. <b>Methods:</b> From October 2023 to April 2024, polymerase chain reaction (PCR) detection of 12 respiratory pathogens was conducted among the general population willing to be tested in the cross-sectional study of 7 cities across the country. Age, gender, and symptom data of the tested population were collected. Chi-square test was used to analyze the differences in HRSV detection rates among different genders, ages, and regions. The temporal distribution of HRSV detection and the situation of co-infection were also analyzed. <b>Results:</b> A total of 459 972 test samples were included, and the age [<i>M</i> (<i>Q₁</i>, <i>Q₃</i>)] was 30 (9,38) with an age range of 0 to 90 years. The total number of HRSV detections was 17 387, with a total detection rate of 3.78%. The HRSV detection rates in the 0-1 year old (11.56%, 1 669/14 440), 2-5 years old (8.09%, 3 746/46 300), 60-74 years old (3.60%, 807/22 386), and≥75 years old (4.31%, 169/3 921) were higher than those in the 6-17 years old (2.93%, 3 238/110 502) and 18-59 years old (2.96%, 7 758/262 423) (<i>P</i><0.003 3). The HRSV detection rate in North China (5.51%, 11 648/211 450) was higher than that in East China (2.41%, 3 964/164 806), South China (2.14%, 1 722/80 579), and Southwest China (1.69%, 53/3 137) (<i>P</i><0.008 3). HRSV in North China showed a single peak epidemic pattern, with an epidemic peak from November 2023 to January 2024; compared with North China, the epidemic period of HRSV in South China started earlier, with epidemic peaks in October 2023 and March-April 2024; in East China, HRSV showed epidemic peaks in early January 2024 and March 2024. Among the HRSV-detected population, the proportion of HRSV co-detected with one pathogen was the highest (46.62%, 8, 106/17, 387), with the highest proportion being HRSV co-detected with one bacterium (43.42%, 7, 549/17, 387). <b>Conclusions:</b> The findings from the direct-to-consumer testing of respiratory pathogens during the winter and spring of 2023-2024 reveals that HRSV is predominantly detected in children aged 0-5 years old and elderly individuals≥60 years old. The epidemic period for HRSV in South China precedes that in North China. Furthermore, HRSV is frequently associated with a specific type of bacteria.