{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T06:27:00Z","timestamp":1786688820333,"version":"build-2736575974"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"\n Background<\/jats:title>\n Pediatric acute respiratory tract infections bring heavy global disease burden. Clarifying post-pandemic epidemiological features guides clinical management and public health prevention.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective study enrolled patients under 18 years receiving 13-pathogen multiplex PCR at West China Second University Hospital from 2023 to 2025. We extracted laboratory data and calculated pathogen positivity, single\/co-infection proportions. Stratified analyses by year, season, age and sex and statistical collation of co-infection patterns were completed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n In total, 32,125 children were included. The total pathogen positive rate reached 63.4%, including 49.8% single infection and 13.6% co-infection dominated by dual infection. Human rhinovirus (22.9%) ranked first, followed by respiratory syncytial virus (15.2%). Pathogens varied obviously across seasons and ages: HRV surged in spring and autumn; parainfluenza, adenovirus and coronavirus prevailed in summer; syncytial virus and influenza peaked in winter. Respiratory syncytial virus mainly affected infants; rhinovirus and parainfluenza were prevalent in toddlers and preschoolers; Mycoplasma pneumoniae rose with age and peaked among school-age children. Dual infection occupied nearly all co-infections; the top non-influenza combinations were HRSV\u2013HRV and HRV\u2013HAdV. Infections with three or more pathogens were rare.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n HRV and HRSV dominated pediatric respiratory pathogens with obvious seasonal and age clustering. Most co-infections occurred in winter and young kids. HRV detection requires careful explanation for potential asymptomatic carriage. Local epidemiological characteristics should inform age-and seasonal-targeted diagnosis and targeted prevention including HRSV prevention.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fped.2026.1884107","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T05:32:14Z","timestamp":1786685534000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiology, temporal trends and co-infection of 13 respiratory pathogens in 32,125 children: a 3-year retrospective study"],"prefix":"10.3389","volume":"14","author":[{"given":"Yu","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of General Pediatrics, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoming","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education","place":["Chengdu, Sichuan, 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