Pertussis-like syndrome often not associated withBordetella pertussis: 5-year study in a large children's hospital

摘要

Background:Recently, a resurgence of pertussis has been observed worldwide despite broad vaccination coverage. The purpose of this study was to identify the clinical characteristics and the aetiological agent of pertussis-like syndrome (PLS) in Eastern China. Methods:1168 patients who were diagnosed with a suspectedBordetella pertussisin Shanghai Children's Hospital from 2013 to 2017 were included in the study. Clinical features and aetiologies were analysed. Aetiological analyses in sub-cohorts of age, seasons and years were also investigated. Results:96.0% (1121) of the patients were less than 12 months old. 59.0% (689) of the patients were male. The Top 5 pathogens were respiratory syncytial virus (RSV;n = 125; 10.7%),Streptococcus pneumonia(SP;n = 109; 9.3%),Haemophilus influenzaetype b (HIB;n = 86; 7.4%),Bordetella pertussis(B. pertussis;n = 84; 7.2%), andMycoplasma pneumonia(MP;n = 80; 6.9%), respectively. The percentage of SP in the age group of 0-3 months was significantly lower than that in other age groups. The percentage ofB.pertussisin the age group of 3-6 months was significantly lower than that in the group of 6-12 months. The percentage of MP in 0-3 months' group was significantly lower than that in >12 months group. RSV peaked in winter (n = 52), while HIB peaked in spring (n = 38). Conclusion:PLS occurred most often in infants. RSV, SP, HIB,B.pertussis, and MP were the most prevalent pathogens. Since patients withB.pertussisand other pathogens have similar clinical manifestations, diagnosis of pertussis should be based on both clinical symptoms and laboratory confirmation.