Chuk Lai-Man R, Lambert Stephen B, May Meryta L, Beard Frank H, Sloots Theo P, Selvey Christine E, Nissen Michael D
Queensland Paediatric Infectious Diseases Laboratory, Sir Albert Sakzewski Virus Research Center, Royal Children's Hospital, Brisbane, Queensland.
Commun Dis Intell Q Rep. 2008 Dec;32(4):449-56. doi: 10.33321/cdi.2008.32.44.
In terms of adverse outcomes, infants remain the group most vulnerable to severe pertussis disease. Adult household contact is thought to be the main source of transmission to infants. This study reviews exposure history, vaccination status, admission outcome and quality of discharge coding of hospitalised infants with pertussis at a tertiary paediatric hospital. We identified cases between 1997 and 2006 from 2 sources: hospital discharge coding and positive Bordetella pertussis results from the hospital laboratory database. We assessed the completeness of each of these sources, compared with the dataset of all identified cases. We identified 55 hospitalised infants with pertussis. The 35 cases (64%) less than 3 months of age had greater risk of Intensive Care Unit admission, higher mortality, and were more likely to have parents as an identified source. On admission, only 5 cases (9%) were more than 2 weeks overdue for their previous scheduled pertussis vaccination. Discharge coding was more sensitive for identifying cases than the laboratory database. Nine cases (16%) had incorrect discharge coding. Even infants up to date for pertussis vaccine can have severe disease requiring hospitalisation. Immunising parents planning to have, or who have had, a newborn baby may help to prevent pertussis in infants.
就不良后果而言，婴儿仍然是最易患严重百日咳疾病的群体。家庭中的成人接触者被认为是婴儿感染的主要传播源。本研究回顾了一家三级儿科医院中住院百日咳婴儿的接触史、疫苗接种状况、入院结局及出院编码质量。我们从两个来源确定了1997年至2006年间的病例：医院出院编码和医院实验室数据库中百日咳博德特氏菌的阳性结果。我们将这些来源中的每一个与所有确诊病例的数据集进行比较，评估其完整性。我们确定了55例住院百日咳婴儿。35例（64%）年龄小于3个月的婴儿入住重症监护病房的风险更高、死亡率更高，且其父母更有可能是已确定的感染源。入院时，只有5例（9%）比之前预定的百日咳疫苗接种时间逾期超过2周。出院编码在识别病例方面比实验室数据库更敏感。9例（16%）出院编码有误。即使是接种了百日咳疫苗的婴儿也可能患严重疾病而需要住院治疗。为计划生育或已生育新生儿的父母接种疫苗可能有助于预防婴儿百日咳。
