Pathogen analysis of pertussis-like syndrome in children

BMC Infect Dis. 2020 May 19;20(1):353. doi: 10.1186/s12879-020-05074-8.

Abstract

Background: The aim of the study was to identify the pathogens, in addition to bordetella pertussis (B. pertussis), which cause pertussis-like syndrome in children and to compare clinical presentation between those with B. pertussis and pertussis-like syndrome.

Methods: A cross-sectional analysis was conducted from March 2016 to September 2018. In total, 281 children with suspected pertussis infections were enrolled in this study. Multi-pathogen detection was performed.

Results: In total, 281 children were enrolled including 139 males and 142 females. Among them, 149 (53.0%) were B. pertussis positive, and 72 (15.6%) children tested positive for other pathogens. Mycoplasma pneumoniae (MP, 27 cases) was the most common causative pathogen in pertussis-like syndrome, followed by human rhinovirus (HRV, 23 cases), Streptococcus pneumoniae (SP, 13 cases), Haemophilus influenzae (HI, 12 cases) and parainfluenza virus 3 (Pinf-3, 9 cases). Children in the B. pertussis group had a higher rate of vaccination and longer hospital stay (P < 0.05). B. pertussis was more likely to be detected in winter than other pathogens, but this difference was not significant (P = 0.074). The number of white blood cells, neutrophils and blood platelets was significantly higher in children in the B. pertussis than in the pertussis-like group (P < 0.05). In addition, the percentage of CD3-CD19+ cells was significantly higher in the B. pertussis group (P = 0.018).

Conclusion: About half of the children with pertussis-like syndrome were B. pertussis positive. MP was the second most common causative pathogen followed by HRV, SP, HI and Pinf-3. Children infected with B. pertussis had longer hospital stay and higher numbers of white blood cells, neutrophil and blood platelets compared with other pathogens.

Keywords: B. Pertussis; Mycoplasma pneumoniae; Pathogen; Pertussis-like syndrome.

MeSH terms

  • Bordetella pertussis / genetics*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Fluorescent Antibody Technique
  • Haemophilus influenzae / genetics*
  • Humans
  • Infant
  • Infant, Newborn
  • Length of Stay
  • Leukocyte Count
  • Male
  • Mycoplasma pneumoniae / genetics*
  • Neutrophils
  • Parainfluenza Virus 3, Human / immunology*
  • Platelet Count
  • Real-Time Polymerase Chain Reaction
  • Rhinovirus / genetics*
  • Streptococcus pneumoniae / genetics*
  • Syndrome
  • Whooping Cough / diagnosis*
  • Whooping Cough / virology