Ferrer A, Calicó I, Manresa J M, Andreu A, Moraga F, Valle I
Servei de Microbiologia, Hospital Vall d'Hebron, Pg Vall d'Hebron 119-129, 08035 Barcelona.
Enferm Infecc Microbiol Clin. 2000 Nov;18(9):433-8.
To describe the etiologic study of the pertussis-like syndrome, not only as far as Bordetella genus is concerned but also regarding the causative role of other microorganisms for a 11-year period (1988-1998).
In all specimens from patients suffering from pertussis-like cough the presence of Bordetella spp., other bacteria, viruses, and mycoplasma was investigated. The analysed data included microbiological findings and epidemiologic issues (age, sex, hospital admission area, yearly distribution and seasonal period).
A total of 1,063 specimens were investigated, most of them nasopharyngeal aspirates (910), corresponding to 905 patients; a positive culture was obtained form 56.9 of these patients. B. pertussis was isolated from 10.5% of patients. As for other bacteria, Haemophilus influenzae and Streptococcus pneumoniae were also isolated, in 16.9% and 15.8% of occasions, respectively. The respiratory syncitial virus was isolated from 10.7% of patients and other viruses in 9.4%. Among mycoplasma, Ureaplasma urealyticum predominated, with a recovery rate of 2.9%. The male/female ratio was 495/410; the ages of 67.2% of patients ranged from 0 to 6 months; a total of 689 (76.1%) required hospital admission. The recovery of B. pertussis and adenoviruses predominated during spring and summer months. In contrast, H. influenzae, S. pneumoniae and respiratory syncitial virus were recovered more frequently during winter months.
Most patients with pertussis-like syndrome are children aged less than 6 months. The recovery percentages of B. pertussis and respiratory syncitial virus are identical and therefore we think that the investigation of their presence in this syndrome is fully warranted as well as the search for other microorganisms, since clinical symptoms are commonly non-specific among infants.
描述百日咳样综合征的病因学研究,不仅涉及博德特氏菌属,还包括其他微生物在11年期间(1988 - 1998年)的致病作用。
对所有患有百日咳样咳嗽患者的标本进行检测,调查其中博德特氏菌属、其他细菌、病毒和支原体的存在情况。分析的数据包括微生物学结果和流行病学问题(年龄、性别、入院地区、年度分布和季节)。
共调查了1063份标本,其中大部分为鼻咽抽吸物(910份),对应905名患者;这些患者中有56.9%培养结果呈阳性。10.5%的患者分离出百日咳博德特氏菌。至于其他细菌,分别在16.9%和15.8%的病例中分离出流感嗜血杆菌和肺炎链球菌。10.7%的患者分离出呼吸道合胞病毒,9.4%的患者分离出其他病毒。在支原体中,解脲脲原体占主导,回收率为2.9%。男女比例为495/410;67.2%的患者年龄在0至6个月之间;共有689例(76.1%)需要住院治疗。百日咳博德特氏菌和腺病毒在春季和夏季的回收率较高。相比之下,流感嗜血杆菌、肺炎链球菌和呼吸道合胞病毒在冬季的回收率更高。
大多数百日咳样综合征患者为6个月以下的儿童。百日咳博德特氏菌和呼吸道合胞病毒的回收率相同,因此我们认为对它们在该综合征中的存在情况进行调查以及寻找其他微生物是完全必要的,因为婴儿的临床症状通常不具有特异性。