AUTHOR=Li Meijin , Wang Jing , Yao Zhongwei , Liao Hailing , Su Shufen , Yang Xuying , Xie Mingzhou , Zheng Yinan TITLE=Metagenomic-based pathogen surveillance for children with severe pneumonia in pediatric intensive care unit JOURNAL=Frontiers in Public Health VOLUME=Volume 11 - 2023 YEAR=2023 URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1177069 DOI=10.3389/fpubh.2023.1177069 ISSN=2296-2565 ABSTRACT=Pneumonia is a significant cause of morbidity and mortality in children. Metagenomic next-generation sequencing (mNGS) has the potential to assess the landscape of pathogens responsible for severe pulmonary infection. Here, 262 children with suspected pulmonary infections who admitted to a Pediatric Intensive Care Unit (PICU) were enrolled, and 251 of them were diagnosed with severe pneumonia. mNGS and conventional tests were conducted for pathogen detection, with 80 underlying pathogens identified. Respiratory syncytial virus (RSV), Staphylococcus aureus and rhinovirus were the most frequently detected pathogens in this cohort. The incidence rate of co-infection was high (58.96%, 148/251), with bacterial-viral agents most co-detected. RSV was the main pathogen in children younger than 6 months of age, and was also commonly found in older pediatric patients. Rhinovirus was prevalent in children older than 6 months. Adenovirus and Mycoplasma pneumoniae were more prevalent in children older than 3 years than in other age groups. Pneumocystis jirovecii was detected in nearly 15% of children younger than 6 months. Besides, influenza virus and adenovirus were rarely found in 2020 and 2021.