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Characteristics, clinical manifestations, and severe disease risk of Bordetella pertussis infection in children: a

Jiangyang Zhao1, Lishai Mo2, Xiaoying Chen2

  • 1Medical Science Laboratory, Children's Hospital, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China; Department of Clinical Laboratory, Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|June 27, 2026
PubMed

Insights

Pertussis (Bordetella pertussis) is circulating in Guangxi, China. Sole pertussis infection in children leads to more severe illness, highlighting the need for prompt diagnosis and treatment.

Area of Science:

  • Pediatric Infectious Diseases
  • Epidemiology
  • Microbiology

Background:

  • Pertussis (Bordetella pertussis) is experiencing a global resurgence.
  • Acute respiratory infections (ARIs) in children pose significant public health challenges.
  • Understanding the epidemiology and risk factors for severe pertussis is crucial for effective management.

Purpose of the Study:

  • To investigate the epidemiology of Bordetella pertussis in hospitalized children with ARIs in Guangxi, China.
  • To identify clinical features and risk factors associated with severe pertussis illness.
  • To analyze antimicrobial resistance patterns in detected B. pertussis strains.

Main Methods:

  • Retrospective study of 10,153 hospitalized children with ARIs (April 2021-December 2024).
  • Pathogen identification using targeted next-generation sequencing (tNGS).
  • Multivariate logistic regression to determine risk factors for intensive care unit (ICU) admission.

Main Results:

  • B. pertussis detected in 3.4% of children, predominantly infants (<1 year).
  • Mono-detection of B. pertussis was linked to younger age, higher bacterial load, and more severe outcomes (higher ICU rates, longer hospital stays).
  • Independent risk factors for ICU admission included younger age, prolonged fever, atelectasis, and co-detection with enterovirus. 51.5% of strains showed macrolide resistance genes.

Conclusions:

  • Bordetella pertussis is actively circulating in Guangxi, China, among pediatric ARI cases.
  • Sole B. pertussis infection is associated with more severe clinical presentations compared to co-infections.
  • Early recognition and intervention are vital, considering risk factors like young age, prolonged fever, atelectasis, and enterovirus co-infection.
Abstract

Keywords:
Bordetella pertussisChildrenCo-detectionSevere diseasetNGS

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