Analysis of clinical characteristics of severe pertussis in infants and children: a retrospective study

Abstract

Background The incidence of pertussis shows an increasing trend in recent years, but some clinicians often lack sufficient understanding of the clinical characteristics and risk factors for severe pertussis, and more effective measures should be taken to reduce the incidence and mortality of pertussis in young infants Methods A retrospective study was conducted, and 184 infants and children with pertussis who had been hospitalized in the Department of Pediatrics of Beijing Ditan Hospital affiliated with Capital Medical University from January 2016 to December 2017 were included. Clinical data of the patients were collected and the clinical characteristics were statistically analyzed Results Among the 184 patients, 41.85% were infants < 3 months of age, and 65.22% of the total patients were not vaccinated against pertussis. There were 22 critically ill children, among whom 4 died, and compared with mild cases, they had a higher proportion of children younger than 3 months of age and infants not vaccinated against pertussis (63.64% vs. 38.89% and 100% vs. 60.49%, respectively); a higher proportion of children with severe pneumonia (100% vs. 0%); higher leukocyte count(× 109/L , 35.80 ± 20.53 vs 19.41 ± 8.59); and a higher proportion of children with severe hyperleukocytosis (18.18% vs. 0%, respectively) (P<0.05) Conclusions 1. Infants aged <3 months not vaccinated for pertussis appear more likely to become infected and have more severe disease. 2. Severe pneumonia and hyperleukocytosis are the main mechanisms underlying severe pertussis.

Risk factors and prediction model of severe pertussis in infants < 12 months of age in Tianjin, China

“…The infants with pertussis were divided into two groups according to the severity of disease: severe pertussis group and non-severe pertussis group. The diagnosis of non-severe pertussis and severe pertussis was consistent with the report of Wang et al [ 14 ]. Those who met the clinical diagnostic criteria for pertussis in the "Suggestions for Diagnosis and Treatment of Pertussis in Children in China" and those who were detected positive by B. pertussisis culture or polymerase chain reaction (PCR) test were diagnosed as non-severe pertussis [ 15 ].…”

“…Pertussis caused by infection with B. pertussisis predominantly seen in infants, some occurrence of complications could lead to severe pertussis, such as pneumonia, apnea, leukocytosis, pulmonary hypertension, seizures and encephalopathy [ 14 , 16 , 17 ]. A recent 5-year surveillance study from Switzerland reported an incidence of laboratory confirmed pertussis of 38.8/100,000 in infants less than 12 months old [ 21 ].…”

“…Those who met the clinical diagnostic criteria for pertussis in the "Suggestions for Diagnosis and Treatment of Pertussis in Children in China" and those who were detected positive by B. pertussisis culture or polymerase chain reaction (PCR) test were diagnosed as non-severe pertussis [ 15 ]. Infants with pertussis who also have the following complications were diagnosed as severe pertussis: such as pneumonia, apnea, leukocytosis, pulmonary hypertension, seizures and encephalopathy [ 14 , 16 , 17 ].…”

Association Between Real-time Polymerase Chain Reaction Cycle Threshold Value and Clinical Severity in Neonates and Infants Infected With Bordetella pertussis

“…WBC count on admission was associated with outcome and mortality in multiple studies. 15,[26][27][28] We demonstrated a similar result, higher WBC count was associated with severe disease. A high WBC count could sludge pulmonary arteries, or toxins produced by B. pertussis could lead to pulmonary hypertension, a major complication of pertussis in neonates and infants.…”

Community acquired Acinetobacter baumannii in pediatric patients under 1 year old with a clinical diagnosis of whooping cough in Lima, Peru

“…We suspect that most of the patients were colonized by community-acquired A. baumannii, given that samples were taken upon admission to hospitalization . The presence of A. baumannii in relation to whooping cough have also been reported previously, for example, it has been detected in children with whooping cough as a complication, causing severe pertussis and pneumonia [ 21 ]. However, this is the first report of this pathogen in young pediatric patients with community-acquired A. baumannii.…”