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Prevalence of B. pertussis infection in children with clinically suspected pertussis
Wujun Jiang1, Luyi Mao2, Kun Wang3
1Department of Respiratory Medicine, Children's Hospital of Soochow University, China; Department of Internal Medicine, Children's Hospital of Wujiang District, Suzhou, China.
Insights
Bordetella pertussis infection in children often involves coinfections, primarily with rhinovirus, Mycoplasma pneumoniae, and human bocavirus. Factors like coinfection, young age, and high WBC count predict longer hospital stays for pertussis patients.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Pertussis (whooping cough) is a significant cause of pediatric hospitalizations.
- Data on pertussis in China are limited, necessitating further clinical characterization.
- This study aimed to analyze pertussis in children and identify predictors of prolonged hospitalization.
Purpose of the Study:
- To characterize clinically suspected pertussis caused by Bordetella pertussis in children.
- To determine factors associated with extended hospital stays in children with B. pertussis infection.
Main Methods:
- Prospective enrollment of 217 children with suspected pertussis from January 2016 to August 2017.
- Assessment of patient demographics, clinical symptoms, and laboratory findings.
- Application of Cox proportional hazards regression to identify factors linked to longer hospitalizations.
Main Results:
- Bordetella pertussis was identified in 48.8% (106/217) of children.
- Coinfections were prevalent (59.4%), with common agents including rhinovirus (30.2%), Mycoplasma pneumoniae (29.2%), and human bocavirus (11.3%).
- Coinfection, age ≤3 months, and WBC count ≥30 × 10^9/L were independently associated with longer hospital stays.
Conclusions:
- Bordetella pertussis infections in children frequently present with coinfections.
- Coinfection, young infant age (≤3 months), and elevated WBC count (≥30 × 10^9/L) are key predictors of prolonged hospitalization.
- Close monitoring of pediatric pertussis patients with these risk factors is crucial for optimal care.
Background:
Pertussis is an important cause of hospitalization in children. Limited data on pertussis have been reported from China. The aim of this study was to characterize clinically suspected pertussis attributable to Bordetella pertussis among children and determine factors associated with longer duration of hospital stay in B. pertussis infection.
Methods:
Two hundred and seventeen consecutive children with clinically suspected pertussis were prospectively enrolled in the study between Jan 2016 through Aug 2017. Variables assessed included demographics, clinical symptoms and laboratory findings. Cox proportional hazards regression model were used to predict variables associated with longer duration of hospital stay.
Results:
Among the 217 patients with clinically suspected pertussis, B. pertussis was found in 106 (48.8%) patients. Of the 106 children with B. pertussis infection, 63 (59.4%) patients had coinfections with majority due to rhinovirus (HRV) (30.2%), Mycoplasma pneumoniae (29.2%) and human bocavirus (hBoV) (11.3%). Presence of coinfection [odds ratio (OR): 1.73, CI: 1.17-2.54], age ≤ 3 months (OR: 1.51, CI: 1.09 to 2.27), and WBC count ≥30 × 109/L (OR: 1.66, CI: 1.07 to 2.84) were independently associated with a longer hospital stay.
Conclusions:
B. pertussis infection had a high coinfection rate with the majority of coinfections due to HRV, M. pneumoniae and hBoV. Presence of coinfection, Age ≤3 months and WBC count ≥30 × 109/L were associated with a longer hospital stay. Children admitted with pertussis need close monitoring when they had evidence of coinfection, Age ≤3 months, WBC count ≥30 × 109/L.
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