Mi Rong, Fu Jin, Wang Xiao-ying, Kang Li-min, Li Li, Xu Fang-sheng, Cui Xiao-dai
Department of Neonatal Medicine, Affiliated Children's Hospital, Capital Institute of Pediatrics, Beijing 100020,China.
Zhonghua Yi Xue Za Zhi. 2013 Jun 11;93(22):1721-5.
To explore the prevalence of Bordetella pertussis (B. pertussis) infection in unvaccinated or incomplete vaccinated infants with cough for a prolonged duration.
The serum samples and nasopharyngeal secretions were collected from 176 patients with cough for a prolonged duration ( ≥ 2 weeks) from 2011 to 2012 at Children's Hospital Affiliated to Capital Institute of Pediatrics. Multiplex PCR of nasopharyngeal secretion was employed to identify B.pertussis. And enzyme-linked immunosorbent assay(ELISA) was used to detect antibody to pertussis toxin(PT-IgG). Total bacterial DNA was enacted from nasopharyngeal secretion and two-target IS481/PT of B.pertussis was detected by PCR. The sera and nasopharyngeal secretions were also collected from household contacts with cough for a prolonged duration. Their clinical characteristic and epidemiological profiles were collected and analyzed.
B.Pertussis infection was demonstrated in 51 cases (29.0%). The patients ages were from 23 days to 4 years. Among them, 46 cases (90.2%) were aged under 12 months and 5 cases (9.8%) over 12 months. And 40 cases were unvaccinated (31 cases <3 months old, 4 cases 3-12 months old, 5 cases >5 years old) and 11 cases incompletely vaccinated. There were 31 males and 20 females. More patients were found in spring and summer than those in autumn and winter. Nine infant cases had 12 household contacts. Among 12 household contacts, 3 were PCR positive and 12 PT-IgG positive. Pertussis was remarkably critical in infants. Serious complications included failure to thrive, pneumonia, respiratory failure and seizures.
B.pertussis infection is an important cause in unvaccinated or incomplete vaccinated infants with prolonged cough. Peak seasons of pertussis are spring and summer. Undiagnosed adolescents and adults with pertussis may be a significant source for transmission of B.pertussis to other susceptible children. Infants aged under 1 year are at risk for severe pertussis and life-threatening complications. As a rapid and sensitive method of detecting B.pertussis, PCR may be used in early phase.
探讨未接种或未全程接种疫苗的咳嗽持续时间较长的婴幼儿中百日咳博德特氏菌（百日咳杆菌）感染情况。
于2011年至2012年从首都儿科研究所附属儿童医院收集176例咳嗽持续时间较长（≥2周）的患者的血清样本和鼻咽分泌物。采用鼻咽分泌物多重聚合酶链反应（PCR）鉴定百日咳杆菌。并用酶联免疫吸附测定法（ELISA）检测百日咳毒素抗体（PT-IgG）。从鼻咽分泌物中提取总细菌DNA，通过PCR检测百日咳杆菌的双靶点IS481/PT。还收集了咳嗽持续时间较长的家庭接触者的血清和鼻咽分泌物。收集并分析他们的临床特征和流行病学资料。
51例（29.0%）证实有百日咳杆菌感染。患者年龄为23天至4岁。其中，46例（90.2%）年龄在12个月以下，5例（9.8%）年龄在12个月以上。40例未接种疫苗（31例＜3个月大，4例3 - 12个月大，5例＞5岁），11例未全程接种疫苗。男性31例，女性20例。春季和夏季发现的患者比秋季和冬季多。9例婴幼儿病例有12名家庭接触者。在12名家庭接触者中，3例PCR阳性，12例PT-IgG阳性。百日咳在婴幼儿中尤为严重。严重并发症包括发育不良、肺炎、呼吸衰竭和惊厥。
百日咳杆菌感染是未接种或未全程接种疫苗的咳嗽持续时间较长的婴幼儿的重要病因。百日咳的高发季节是春季和夏季。未确诊的青少年和成人百日咳患者可能是百日咳杆菌传播给其他易感儿童的重要传染源。1岁以下婴幼儿有发生重症百日咳和危及生命并发症的风险。作为一种快速、灵敏的检测百日咳杆菌的方法，PCR可用于早期检测。
