Identification of etiologic agents and clinical characteristics for patients suspected of having pertussis in a large Children's Hospital in China

Yue Tao; Mingyu Tang; Lijuan Luo; Long Xiang; Yijun Xia; Biru Li; Qing Cao; Xi Mo

doi:10.21037/atm.2019.08.85

Identification of etiologic agents and clinical characteristics for patients suspected of having pertussis in a large Children's Hospital in China

Ann Transl Med. 2019 Sep;7(18):443. doi: 10.21037/atm.2019.08.85.

Authors

Yue Tao^{1

2}, Mingyu Tang³, Lijuan Luo¹, Long Xiang⁴, Yijun Xia⁵, Biru Li⁴, Qing Cao¹, Xi Mo²

Affiliations

¹ Department of Infectious Diseases, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.
² The Laboratory of Pediatric Infectious Diseases, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.
³ Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.
⁴ Pediatric Intensive Care Unit, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.
⁵ Medical Affairs Director, Great China | bioMérieux (Shanghai) Company, Limited, Shanghai 200127, China.

Abstract

Background: In China, pertussis is a major health problem with an increasing incidence despite immunization efforts. Timely and accurate diagnosis is essential for the optimal management of pertussis, especially in severe cases.

Methods: Nasopharyngeal swabs or sputum specimens were obtained from patients suspected of having pertussis on the day of hospitalization at Shanghai Children's Medical Center from December 01, 2016, to November 30, 2017. The specimens were tested with the FilmArray Respiratory Panel, a multiplex polymerase chain reaction (PCR) assay that detects 16 viruses, Bordetella pertussis (B. pertussis), Mycoplasma pneumoniae (M. pneumoniae), and Chlamydophila pneumoniae (C. pneumoniae).

Results: Among the 140 children studied, 50.0% (70/140) were detected with a single pathogen, 45.0% (63/140) were detected with multiple pathogens, and 5.0% (7/140) had no detected pathogens. Forty-nine (35%, 49/140) patients tested positive for B. pertussis. Respiratory syncytial virus (RSV), parainfluenza virus (Para) and rhinovirus/enterovirus (Rhino/Entero) were the most prevalent pathogens in patients with pertussis-like syndrome. No significant differences between the groups with pertussis and pertussis-like syndrome were observed regarding the clinical symptoms. Severe cases were more frequently observed in unvaccinated, premature and pertussis/RSV co-infection patients.

Conclusions: Our study highlights the importance of the timely and accurate diagnosis of pertussis based on both clinical symptoms and laboratory methods.

Keywords: B. pertussis; FilmArray Respiratory Panel; children; pertussis-like syndrome; pertussis/virus co-infections.