Pathogen Epidemiology of Pediatric Acute Respiratory Infections Based on Targeted Next-Generation Sequencing in Guangzhou, China

This study analyzed 355 children with acute respiratory infections in Guangzhou from April to August 2025 using targeted next-generation sequencing of bronchoalveolar lavage fluid. The positive detection rate was 99.4%, and over 90% of patients had co-infections, mainly bacteria-virus combinations. The most common pathogens were Haemophilus influenzae, Streptococcus pneumoniae, Streptococcus mitis, RSV-A, rhinovirus A, and Staphylococcus aureus. Clear age- and month-related patterns were observed, such as RSV-A peaking in infants in June and S. aureus being more frequent in adolescents with a July peak. Overall, the findings show that tNGS can sensitively detect a wide range of pathogens and can support more accurate diagnosis, better antimicrobial decision-making, and improved prevention of respiratory infections in children.