Air pollution is a crucial risk factor for respiratory
infection. However, the relationships between air pollution and respiratory
infection based on pathogen detection are scarcely explored in the available literature. We detected
respiratory infections through patient-based bacterial culture in sputum, obtained hourly data of all six
pollutants (PM2.5, PM10, SO2, NO, CO, and O3) from four air quality monitoring stations, and assessed the relationships of
air pollutants and respiratory
bacterial infection and multi-drug-resistant bacteria. Air pollution remains a challenge for Mianyang, China, especially PM2.5 and PM10, and there are seasonal differences; pollution is the heaviest in winter and the lowest in summer. A total of 4237 pathogenic bacteria were detected, and the positive rate of multi-drug-resistant bacteria was 0.38%. Similar seasonal differences were found with respect to respiratory
infection. In a single-
pollutant model, all
pollutants were significantly associated with respiratory
bacterial infection, but only O3 was significantly associated with multi-drug-resistant bacteria. In multi-
pollutant models (adjusted for one
pollutant), the relationships of
air pollutants with respiratory
bacterial infection remained significant, while PM2.5, PM10, and O3 were significantly associated with the risk of
infection with multi-drug-resistant bacteria. When adjusted for other five
pollutants, only O3 was significantly associated with respiratory
bacterial infection and the risk of
infection with multi-drug-resistant bacteria, showing that O3 is an independent risk factor for respiratory
bacterial infection and
infection with multi-drug-resistant bacteria. In summary, this study highlights the adverse effects of air pollution on respiratory
infection and the risk of
infection with multi-drug-resistant bacteria, which may provide a basis for the formulation of environmental policy to prevent
respiratory infections.