BACKGROUND: Respiratory tract infections are a major global health concern for children, characterized by significant morbidity and mortality, particularly in resource-limited regions. This study investigated the descriptive epidemiology of common respiratory pathogens among children in Xinjiang, China. METHODS: This retrospective cross-sectional study was conducted on 2364 pediatric outpatients and emergency department visitors aged 0-14 years with respiratory infections from September 2023 to December 2023. Nasopharyngeal swabs were collected and analyzed using multiplex PCR for six common pathogens: influenza A virus (IFVA), influenza B virus (IFVB), respiratory syncytial virus (RSV), adenovirus (ADV), human rhinovirus (HRV), and Mycoplasma pneumoniae (MP). The distribution of pathogens among different age groups was evaluated. RESULTS: No significant sex-based differences were observed in the detection of IFVA, IFVB, RSV, MP, HRV, and ADV (P > 0.05). Among the nasopharyngeal swab samples, 58% (1371/2364) were positive for a single respiratory pathogen, 21.8% (516/2364) for two pathogens, 3.3% (78/2364) for three pathogens, and 0.3% (6/2364) for four pathogens. Notably, IFVA had the highest detection rate (32.6%) among the single infections. HRV was the most frequently identified virus, accounting for 34.8%, followed closely by IFVA at 31.4% and RSV at 20.3%. ADV was detected in 10.4% of cases, while MP and IFVB were found in 8.7% and 7.1% of samples, respectively. The highest pathogen detection rates were observed in children aged 3 to 7 years. Among the co-infections, dual pathogen infections predominated, comprising 86.0% of instances; notably, the combination of IFVA and HRV accounted for 23.3% of these cases. Triple pathogen infections represented 13% of co-infections, with combinations such as RSV, HRV, and ADV being the most prevalent. CONCLUSION: This study highlights the epidemiological profile of respiratory pathogen infections among pediatric outpatients and emergency visitors in Xinjiang, revealing crucial age-specific trends and co-infection patterns. Despite limitations inherent to its single-center, retrospective design, these findings provide a valuable baseline for informing local surveillance and guiding preventive strategies in community healthcare settings. TRIAL REGISTRATION: Not applicable.
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