Division of Infectious Diseases, School of Medicine.
Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City.
J Pediatric Infect Dis Soc. 2018 Dec 3;7(4):310-316. doi: 10.1093/jpids/pix081.
Pertussis is an important cause of hospitalization and death in infants too young to be vaccinated (aged <2 months). Limited data on infant pertussis have been reported from Central America. The aim of this study was to characterize acute respiratory illnesses (ARIs) attributable to Bordetella pertussis among infants enrolled in an ongoing surveillance study in Guatemala.
As part of a population-based surveillance study in Guatemala, infants aged <2 months who presented with ARI and required hospitalization were enrolled, and nasopharyngeal and oropharyngeal swab specimens were obtained. For this study, these specimens were tested for B pertussis using real-time polymerase chain reaction (PCR).
Among 301 infants hospitalized with ARI, we found 11 with pertussis confirmed by PCR (pertussis-positive infants). Compared to pertussis-negative infants, pertussis-positive infants had a higher mean admission white blood cell count (20900 vs 12579 cells/μl, respectively; P = .024), absolute lymphocyte count (11517 vs 5591 cells/μl, respectively; P < .001), rate of admission to the intensive care unit (64% vs 35%, respectively; P = .054), and case fatality rate (18% vs 3%, respectively; P = .014). Ten of the 11 pertussis-positive infants had cough at presentation; the majority (80%) of them had a cough duration of <7 days, and only 1 had a cough duration of >14 days. Fever (temperature ≥ 38°C) was documented in nearly half (45%) of the pertussis-positive infants (range, 38.0-38.4°C).
In this study of infants <2 months of age hospitalized with ARI in Guatemala, pertussis-positive infants had a high rate of intensive care unit admission and a higher case fatality rate than pertussis-negative infants.
百日咳是导致无法接种疫苗（<2 个月龄）婴儿住院和死亡的一个重要原因。中美洲有关于婴儿百日咳的有限数据报告。本研究旨在描述危地马拉正在进行的监测研究中纳入的婴儿中由百日咳博德特氏菌引起的急性呼吸道疾病（ARI）。
作为危地马拉基于人群的监测研究的一部分，我们招募了患有 ARI 且需要住院的<2 个月龄婴儿，并采集鼻咽和口咽拭子标本。在这项研究中，我们使用实时聚合酶链反应（PCR）检测这些标本中的 B 型百日咳。
在 301 名因 ARI 住院的婴儿中，我们发现有 11 例通过 PCR 确诊为百日咳（百日咳阳性婴儿）。与百日咳阴性婴儿相比，百日咳阳性婴儿的平均入院白细胞计数（分别为 20900 和 12579 个细胞/μl；P=0.024）、绝对淋巴细胞计数（分别为 11517 和 5591 个细胞/μl；P<0.001）、入住重症监护病房的比例（分别为 64%和 35%；P=0.054）和病死率（分别为 18%和 3%；P=0.014）均较高。11 例百日咳阳性婴儿中有 10 例在就诊时出现咳嗽；他们中的大多数（80%）咳嗽持续时间<7 天，只有 1 例咳嗽持续时间>14 天。近一半（45%）的百日咳阳性婴儿有发热（体温≥38°C）（范围为 38.0-38.4°C）。
在危地马拉因 ARI 住院的<2 个月龄婴儿中，百日咳阳性婴儿的重症监护病房入住率和病死率均高于百日咳阴性婴儿。
