Molecular Epidemiology of Pediatric Respiratory Infections in Xinjiang, China: A Cross-Sectional Study of Six Pathogens

Purpose: We analyzed the epidemiological and etiological characteristics of six prevalent pathogens responsible for respiratory infections in pediatric patients. Patients and Methods: This retrospective cross-sectional study involved 6134 children with respiratory infections from January 2024 to December 2024. Nasopharyngeal swabs were collected and analyzed using multiplex PCR to detect Influenza A (IFVA) and B viruses (IFVB), Respiratory Syncytial Virus (RSV), Adenovirus (ADV), Human Rhinovirus (HRV), and Mycoplasma pneumoniae (MP). Pathogen distribution was assessed. Results: Among the six pathogens tested, HRV and ADV were the most frequently detected, followed by MP, RSV, IFVB, and IFVA. Single-pathogen infections accounted for 62.3% of cases, while co-infections of two, three, and four pathogens comprised 13.5%, 2.2%, and 0.08%, respectively. The most common co-infection pattern was HRV+ADV. Age-specific analysis revealed distinct shifts: RSV predominated in infants under 1 year, HRV and ADV were most common in preschool children aged 3–< 7 years, and MP dominated in school-aged children aged 7– 14 years (all P < 0.001 across age groups). Seasonally, RSV peaked in spring and winter, ADV in summer, HRV in winter, and IFVB showed an unusual spring peak (all P < 0.001). No significant sex differences were observed except for ADV, which was slightly higher in males (P = 0.009). Conclusion: This first comprehensive analysis of pediatric respiratory infections in Xinjiang reveals epidemiological patterns distinct from other Chinese regions, characterized by atypical seasonal peaks (spring IFVB, summer ADV, winter HRV) and age-specific pathogen shifts (RSV in infants, MP in school-aged children), with HRV+ADV as the dominant co-infection. These findings highlight the necessity of region-tailored prevention strategies and provide a baseline for future surveillance in understudied continental climate populations.