Objective To analyze the non-bacterial pathogen of community-acquired pneumonia in hospitalized children in a hospital in Ningbo, understand the spread pattern of pneumonia pathogens in local area, and provide evidence for clinical prevention, diagnosis and treatment of community-acquired pneumonia.

Methods A total of 3807 children with community-acquired pneumonia admitted to the Affiliated People’s Hospital of Ningbo University from September 2022 to August 2024 were selected. Throat swabs were collected from them, PCR capillary electrophoresis fragment analysis was used to detect the nucleic acids of the following 13 respiratory pathogens, including influenza A virus, A (H1NI) virus, A (H3N2) virus, influenza B virus, adenovirus, human bocavirus, respiratory syncytial virus, rhinovirus, metapneumovirus, coronavirus, parainfluenza virus, Mycoplasma pneumoniae and chlamydia, the results were analyzed by χ² test.

Results The proportion of hospitalized children with pneumonia was 72.22%, the positive rate was 85.76%. Respiratory syncytial virus was most commonly detected in age group 1 year, while M. pneumoniae was most commonly detected in other age groups. The proportion of children infected with M. pneumoniae was 55.66%; most of them were 4 years old and above. Children with respiratory syncytial virus infections were mainly under 5 years old. Adenovirus infections were distributed in all the age groups, mainly in age group 1−<7 years. The children with Chlamydial infection were mainly aged ≥10 years. Human bocavirus infection mainly occurred in infants. The proportion of co-infections was 15.34%. Coronavirus (79.31%), rhinovirus (59.87%), bocavirus (55.88%), influenza B virus (54.37%) were mostly detected in co-infection cases. HRSV infections occurred in four seasons, and adenovirus infection occurred in spring and summer.

Conclusion Pneumonia was the most common cause of hospitalization in children, non-bacterial pathogen infection rate was high, and M. pneumoniae was the most common non-bacterial pathogen. Different pathogens affected specific age groups. Co-infection with multi pathogens was not rare. Coronavirus was mainly detected in co-infections. Respiratory syncytial virus and adenovirus infections showed specific area distributions.