Objective:

To characterize the profiles of respiratory potentially pathogenic bacteria (PPB) in neonates with RSV, focusing on their detection rates and associations with clinical outcomes.

Key Findings:

• 33.9% of RSV-positive neonates had detectable respiratory PPB compared to 25.7% of RSV-negative cases (P < 0.001).
• Severe RSV cases had a higher proportion of preterm births, underlying conditions, and PPB detection (P < 0.05).
• Neonates with both RSV and PPB showed higher rates of high fever, feeding difficulty, cardiovascular complications, and required more oxygen therapy.

Interpretation:

The presence of respiratory PPB in neonates with RSV is associated with increased disease severity and complications, suggesting that the respiratory microbiome may play a significant role in influencing RSV outcomes.

Limitations:

• Limited data on the specific types of PPB and their individual contributions to disease severity, which may affect the interpretation of results.
• Single-center study may limit the generalizability of findings to broader populations.

Conclusion:

Respiratory PPB detection in neonates with RSV is linked to worse clinical outcomes, highlighting the need for further research on the microbiome's role in RSV infections.