Fig. 1

Overview of study design. The study cohort was comprised of 221 children with acute sinusitis who underwent collection of NP swabs. Culture was used to detect three bacterial species (Haemophilus influenzae, Streptococcus pneumonia, Moraxella catarrhalis) and qRT-PCR was used to detect 12 viruses of clinical relevance. Haemophilus influenzae isolates were tested for beta-lactamase production (N = 69). Parallel to this, RNA extraction from NP swabs and sequencing was also done to conduct metatranscriptomic analysis using a bioinformatics approach. Using the sequencing data, several analyses were performed: pathogen detection and quantification, reconstruction of detected respiratory viruses, detection of beta-lactamase genes, and transcriptomic analysis of host responses