Prevalence of viral and atypical bacterial respiratory pathogens among pediatric patients with acute respiratory infections after COVID-19 in Ningbo, China

Abstract Background To investigate the prevalence and distribution of viral and atypical bacterial respiratory pathogens among pediatric patients with acute respiratory illnesses in Ningbo, China, following the COVID-19 pandemic, and to describe their seasonal trends and epidemiological characteristics. Methods A retrospective observational study was conducted using throat swab samples collected from 34,404 pediatric patients(aged ≤ 18 years)presenting with respiratory symptoms at the Affiliated Women and Children’s Hospital of Ningbo University from January 2023 to December 2024. Multiplex polymerase chain reaction (mPCR) was used to detect 13 common viral and atypical bacterial respiratory pathogens. Data on demographics, pathogen types, and sample collection dates were retrieved from the laboratory database and analyzed. Results The overall positivity rate for respiratory pathogens was 69.14%. Mycoplasma pneumoniae (Mp) (26.94%), human rhinovirus (HRV) (16.29%), and human adenovirus (HADV) (9.00%) were the most prevalent pathogens. Significant differences in pathogen positivity rates were observed between sexes and across age groups. Seasonal variations were evident for certain pathogens. Coinfections were detected in 19.85% of the positive samples, with dual infections being the most common. Conclusion This study highlights the significant role of Mp, HRV, and HADV in pediatric respiratory infections in Ningbo, China, following the COVID-19 pandemic. These findings underscore the need for continued surveillance and provide valuable epidemiological reference for pediatric respiratory infection management in the post-COVID-19 era. Clinical trial number Not applicable.