Aquino-Andrade Alejandra, Martínez-Leyva Gabriel, Mérida-Vieyra Jocelin, Saltigeral Patricia, Lara Antonino, Domínguez Wendy, García de la Puente Silvestre, De Colsa Agustín
Molecular Microbiology Laboratory, National Institute of Pediatrics, Mexico City, Mexico.
Department of Pediatric Infectious Diseases, National Institute of Pediatrics, Mexico City, Mexico.
J Pediatr. 2017 Sep;188:217-223.e1. doi: 10.1016/j.jpeds.2017.05.032. Epub 2017 Jun 13.
To evaluate the usefulness of real-time polymerase chain reaction (RT-PCR) as a diagnostic method for the detection of Bordetella pertussis in hospitalized patients aged <1 year with a clinical diagnosis of whooping cough, as well as to identify the role of household contacts as a source of infection.
This was a prospective, multicenter study of infants aged <1 year who were hospitalized with symptoms suggestive of whooping cough. Nasopharyngeal samples were obtained for culture and RT-PCR testing. The clinical and epidemiologic characteristics and outcomes were analyzed. B pertussis detection and symptoms in household contacts of patients diagnosed with pertussis were studied.
A total of 286 patients were included; of these, 67.1% had B pertussis and 4.5% had Bordetella spp. Complications occurred in 20% of patients, and the mortality rate was 6.7%. Of 434 contacts studied, 111 were mothers of study infants, representing the most frequently B pertussis-infected group and the main symptomatic contact.
The use of RT-PCR permits improved detection and diagnosis of pertussis and a better understanding of the epidemiology of sources of infection. The complications and mortality rate of pertussis continue to be high. Household contacts are confirmed as a frequent source of infection of B pertussis in young children.
评估实时聚合酶链反应（RT-PCR）作为诊断方法用于检测临床诊断为百日咳的1岁以下住院患者中百日咳博德特氏菌的效用，并确定家庭接触者作为感染源的作用。
这是一项针对1岁以下出现百日咳疑似症状而住院婴儿的前瞻性多中心研究。采集鼻咽样本进行培养和RT-PCR检测。分析临床和流行病学特征及结果。研究确诊百日咳患者家庭接触者中的百日咳博德特氏菌检测情况和症状。
共纳入286例患者；其中，67.1%感染百日咳博德特氏菌，4.5%感染博德特氏菌属。20%的患者出现并发症，死亡率为6.7%。在研究的434名接触者中，111名是研究婴儿的母亲，是最常感染百日咳博德特氏菌的群体，也是主要的有症状接触者。
使用RT-PCR可改善百日咳的检测和诊断，并更好地了解感染源的流行病学情况。百日咳的并发症和死亡率仍然很高。家庭接触者被确认为幼儿百日咳博德特氏菌的常见感染源。
