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Bordetella Pertussis Infection in Hospitalized Infants with Acute Bronchiolitis
Şule Gökçe1, Zafer Kurugöl2, S Şöhret Aydemir3
1Department of Pediatrics, General Pediatrics Unit, Ege University, Izmir, Bornova, Turkey.
Insights
Bordetella pertussis infection is common in infants hospitalized with acute bronchiolitis, often co-infecting with viruses. Pertussis infection did not alter the clinical outcome or severity of bronchiolitis in these young patients.
Area of Science:
- Pediatrics
- Infectious Diseases
- Respiratory Medicine
Background:
- Acute bronchiolitis is a common respiratory infection in infants.
- Bordetella pertussis (pertussis) is a significant pathogen in young infants.
- The role of pertussis in the clinical course of acute bronchiolitis is not well-defined.
Purpose of the Study:
- To determine the frequency of B. pertussis infection in infants hospitalized with acute bronchiolitis.
- To investigate whether B. pertussis infection influences the clinical presentation and severity of acute bronchiolitis.
Main Methods:
- A cohort of 172 infants under 6 months hospitalized with acute bronchiolitis were enrolled.
- Real-time PCR was used to detect B. pertussis and common respiratory viruses.
- Clinical parameters, severity scores, and laboratory data were compared between B. pertussis-positive and negative infants.
Main Results:
- B. pertussis was detected in 25.6% of infants, with 61.4% of these cases being co-infections with other respiratory viruses.
- Characteristic pertussis symptoms like paroxysmal cough, whooping, and post-tussive vomiting were infrequent.
- No significant differences in clinical severity scores (Wang score, overall disease severity) were observed between pertussis-positive and negative infants.
Conclusions:
- B. pertussis infection is a frequent finding in young infants hospitalized for acute bronchiolitis, often as a co-infection.
- Clinical manifestations of pertussis in this age group are often atypical and do not reliably distinguish it from viral bronchiolitis.
- Co-infection with B. pertussis does not appear to worsen the clinical outcome of acute bronchiolitis in hospitalized infants.
Objective:
To assess the frequency of B. pertussis infection among young infants hospitalized with acute bronchiolitis and to determine whether B. pertussis infection affects the clinical course of acute bronchiolitis.
Methods:
A total of 172 infants <6 months of age hospitalized with acute bronchiolitis were tested for B. pertussis and respiratory viruses with real-time PCR. Cases were divided into 2 groups according to B. pertussis positive or negative. Clinical parameters, clinical severity scores and laboratory characteristics of the pertussis-positive and pertussis-negative cases were compared.
Results:
Bordetella pertussis infection was detected in 44 (25.6%) of the 172 infants hospitalized for acute bronchiolitis, and as co-infection with respiratory viral agents in 27 (61.4%) infants. Of the 44 pertussis-positive infants, only 17 (38.6%) experienced a paroxysmal cough, 13 (29.5%) had whooping and 15 (34.1%) had post-tussive vomiting. There was no significant difference between pertussis-positive and pertussis-negative infants according to Wang clinical score at admission (4.9 ± 1.5 vs. 5.2 ± 2.5; p = 0.689). The overall disease severity score was also similar between the two groups (6.5 ± 1.4 vs. 6.9 ± 1.6; p = 0.095).
Conclusions:
Bordetella pertussis infection is common in young infants hospitalized for acute bronchiolitis, mostly as co-infection with respiratory viruses. The clinical features of pertussis in the infants are not characteristic. Viral bronchiolitis and pertussis cases could not be differentiated by clinical findings. Co-infection with pertussis did not affect the clinical outcome in infants hospitalized with acute bronchiolitis.
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