Clinical and prognostic insights into Chlamydia trachomatis in pediatric acute respiratory infections: evidence from targeted next-generation sequencing of 5,021 cases.

Background: Chlamydia trachomatis (CT) is a major cause of respiratory tract infections in children. The primary objective of this research was to evaluate the infection status and clinical manifestations associated with C. trachomatis in these pediatric patients.

Methods: From April 2021 to November 2023, a total of 5,021 hospitalized children with acute respiratory tract infections were collected at the Guangxi Maternal and Child Health Hospital. tNGS was used to detect pathogens in their respiratory samples.

Results: Among the 5,021 hospitalized pediatric patients with acute respiratory tract infections, targeted next-generation sequencing (tNGS) detected C. trachomatis in 138 cases, with a detection rate of 2.75%. Among the 138 cases positive for C. trachomatis, 10 were identified as single C. trachomatis infection, while 128 cases involved co-infections with other pathogens. A total of 36 additional pathogens were detected in children with mixed Chlamydia trachomatis infections, with Pneumocystis jirovecii being the most frequently detected. In children with C. trachomatis infection, pulmonary consolidation and hypoxemia were the most commonly observed respiratory complications, whereas anemia and liver function impairment were the primary complications affecting other organ systems. The median duration of hospitalization for the 138 children was 8 days. Among the 138 children with C. trachomatis infection, 108 cases (78.26%) required respiratory support, and 11 cases (7.97%) required ICU admission.

Conclusion: The detection rate of C. trachomatis among hospitalized pediatric patients with respiratory tract infections was 2.75%. This study delineates the clinical manifestations and infection patterns of C. trachomatis in Guangxi, China.