ObjectiveTo analyze the distribution characteristics of common non-bacterial pathogens in hospitalized children with acute respiratory tract infection(ARTI) in Suzhou from 2021 to 2023, and to provide a basis for the prevention and treatment of children with ARTI. MethodsA total of 14 953 patients with ARTI admitted to the internal medicine ward of the Children’s Hospital of Soochow University from September 2021 to July 2023 were retrospectively selected. Multiple RTFQ-PCR and capillary electrophoresis were used to detect 13 respiratory pathogens from throat swab samples, and the pathogen distribution was analyzed. ResultsThe total detection rate of respiratory virus in the14 953 hospitalized children with ARTI was 76.23% (11 398/14 953). Single infection accounted for 75.10% (8 560/11 398), while mixed infection accounted for 24.90% (2 838/11 398). The top three pathogens detected were rhinovirus (23.35%, 3 492/14 953), respiratory syncytial virus (19.53%, 2 920/14 953), and Mycoplasma pneumoniae(MP) (13.31%, 1 990/14 953). The detection rate of human Bocavirus and rhinovirus were higher in boys than that in girls (P=0.008, P<0.001), while the detection rate of MP was higher in girls than that in boys (P<0.01). The detection rates of RSV and Chlamydia pneumoniae (CP) were the highest in children under 1 year of age. Parainfluenza virus human, Bocavirus, rhinovirus, adenovirus and coronavirus were most commonly detected in children aged between 1‒3 years. The detection rates of influenza A virus, influenza A (H1N1) virus, influenza A (H3N2) virus and metapenu⁃movirus were the highest in children aged between 3‒6 years. The detection rates of influenza B virus and MP were the highest in children older than 6 years. The detection rates of influenza A virus, influenzaA (H1N1) virus and RSV were the highest in spring. The detection rates of influenza A (H3N2) virus and MP were the highest in summer. The detection rates of parainfluenza virus, human Bocavirus, rhinovirus and metapenu-movirus were the highest in autumn. The detection rate of influenza B virus was the highest in winter. The detection rate of respiratory tract viruses varied by type of disease, and the difference is statistically significant (χ²=220.280, P<0.001). The positive rate of respiratory tract virus was 79.15% and 78.83% in patients with bronchitis and bronchopneumonia, respectively. Rhinovirus was the most commonly detected pathogen in patients with bronchitis (42.71%), bronchopneumonia (22.58%), and severe pneumonia (23.19%). ConclusionIn recent years, respiratory tract infections in children in the Suzhou area have primarily been viral infections, with rhinovirus, RSV and MP being the main pathogens. The detection rates of respiratory pathogens vary by age and season.