Objective Using targeted next-generation sequencing technology to explore the composition of the pathogenic spectrum of febrile respiratory syndrome,analyze the epidemic characteristics of the pathogen,summarize the rules,and provide accurate guidance for the treatment strategy of patients with febrile respiratory syndrome.Methods By tNGS detection of 4039 cases with fever with respiratory diseases in four hospitals in Tianjin in 2023,pathogenic microorganisms were analyzed and identified,and the distribution of pathogenic microorganisms,age distribution,gender distribution,infection distribution in different times and seasons,and distribution trend of microbial types in different specimen types were studied.Results In 4039 cases,90 potential pathogens were detected,the total positive rate was 94.80%(3 829/4 039),including 36 kinds of bacteria,29 kinds of viruses,5 kinds of atypical pathogen and 6 kinds of fungi.The order of detection frequency of different types of pathogens:G-bacteria＞RNA virus＞DNA virus＞G+bacteria＞fungi＞atypical pathogens.There was no significant difference in the positive rate of male and female between the two groups(χ2=0.249,P=0.618).The pathogen spectrum of different age groups was heterogeneous.The positive patients were mostly distributed in 0-10 years old[47.90%(1 834/3 829)]and＞60 years old[31.23%(1 196/3 829)].Among the single infection,Mycoplasma pneumoniae accounted for the highest proportion,4.91%(188/3829),followed by 2019-nCoV,1.59%(61/3 829),and respiratory syncytial virus,1.23%(47/3 829).There were differences in different infection types in different seasons,and the overall characteristics of mixed infection rate in summer and winter were high.In summer,the new coronavirus was combined with bacteria(Acinetobacter baumannii,Streptococcus pneumoniae),and in winter,Mycoplasma pneumoniae was combined with influenza A and B viruses.The resistance rate of Mycoplasma pneumoniae to macrolides showed an increasing trend with the time.Conclusions The tNGS technology had obtained a high pathogen detection rate in the samples of febrile respiratory syndrome in Tianjin.By providing more pathogen information,it can be effectively applied to the etiological diagnosis of respiratory infectious diseases and assist in the identification of mixed infections and drug resistance information.
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