To analyze the current status and epidemiological characteristics of different pathogen infections in the respiratory tract of children, providing reference for clinical diagnosis and treatment, as well as for the prevention and control of respiratory infectious diseases in children.

A total of 39, 025 children diagnosed with respiratory tract infections in our hospital from March 2024 to February 2025 were selected. Pharyngeal swab specimens were collected from these children, and nucleic acid testing for six respiratory pathogens was performed using the Natch 48 nucleic acid extraction method. The pathogens tested were Mycoplasma pneumoniae(MP), Influenza B virus (FluB), Influenza A virus (FluA), Respiratory syncytial virus (RSV), Adenovirus (ADV), and Human rhinovirus (HRV).

Among the 39 025 children tested, pathogens were detected in 22 867 cases (58.5%). Among these, single pathogen infections were found in 19 523 cases (85.38%), and mixed pathogen infections were found in 3 344 cases (14.62%). The distribution of the six pathogens among positive cases was as follows: ADV in 6 373 cases (32.64%), HRV in 4 745 cases (24.30%), MP in 4 050 cases (20.75%), FluA in 2 293 cases (11.75%), RSV in 1 346 cases (6.89%), and FluB in 716 cases (3.67%). Among children aged one month to one year, 1 528 pharyngeal swabs were tested, with 730 positive cases (47.77%). Among children aged >1 to 3 years, 5 224 were tested, with 3 950 positive cases (75.61%). Among children aged >3 to 6 years, 17 887 were tested, with 7 372 positive cases (41.21%). Among 7-year-old children, 14 386 were tested, with 7 471 cases (51.93%). Among children living in home-based care settings, 6 752 were tested, with 4 963 positive cases (73.50%). Among children attending kindergarten, 32 273 were tested, with 14 827 positive cases (45.94%). The difference in positive detection rates among children of different age groups was statistically significant (P<0.001). By season, 8 406 tests were performed in spring, with 4 032 positive cases (47.97%); 10 756 tests in summer, with 5 818 positive cases (54.09%); 9 714 tests in autumn, with 4 934 positive cases (50.79%); and 10 149 tests in winter, with 4 739 positive cases (46.69%). The difference in positive detection rates among children across different seasons was statistically significant (P<0.001).

The most common single pathogens causing respiratory infections in children are ADV, HRV, and MP. Mixed respiratory pathogen infections frequently involve combinations of HRV and ADV, as well as HRV and MP, which should receive clinical attention. Prevention and control measures should be formulated based on epidemiological characteristics to reduce the incidence of respiratory pathogen infections in children.