Department of Pediatrics, General Pediatrics Unit, Ege University, Izmir, Bornova, Turkey.
Division of Pediatric Infection, Department of Pediatrics, Ege University, 35700, Izmir, Bornova, Turkey.
Indian J Pediatr. 2018 Mar;85(3):189-193. doi: 10.1007/s12098-017-2480-4. Epub 2017 Oct 27.
To assess the frequency of B. pertussis infection among young infants hospitalized with acute bronchiolitis and to determine whether B. pertussis infection affects the clinical course of acute bronchiolitis.
A total of 172 infants <6 months of age hospitalized with acute bronchiolitis were tested for B. pertussis and respiratory viruses with real-time PCR. Cases were divided into 2 groups according to B. pertussis positive or negative. Clinical parameters, clinical severity scores and laboratory characteristics of the pertussis-positive and pertussis-negative cases were compared.
Bordetella pertussis infection was detected in 44 (25.6%) of the 172 infants hospitalized for acute bronchiolitis, and as co-infection with respiratory viral agents in 27 (61.4%) infants. Of the 44 pertussis-positive infants, only 17 (38.6%) experienced a paroxysmal cough, 13 (29.5%) had whooping and 15 (34.1%) had post-tussive vomiting. There was no significant difference between pertussis-positive and pertussis-negative infants according to Wang clinical score at admission (4.9 ± 1.5 vs. 5.2 ± 2.5; p = 0.689). The overall disease severity score was also similar between the two groups (6.5 ± 1.4 vs. 6.9 ± 1.6; p = 0.095).
Bordetella pertussis infection is common in young infants hospitalized for acute bronchiolitis, mostly as co-infection with respiratory viruses. The clinical features of pertussis in the infants are not characteristic. Viral bronchiolitis and pertussis cases could not be differentiated by clinical findings. Co-infection with pertussis did not affect the clinical outcome in infants hospitalized with acute bronchiolitis.
评估因急性细支气管炎住院的婴幼儿中百日咳博德特氏菌感染的频率，并确定百日咳博德特氏菌感染是否影响急性细支气管炎的临床病程。
对 172 名<6 个月龄因急性细支气管炎住院的婴儿进行实时 PCR 检测以确定是否感染百日咳博德特氏菌和呼吸道病毒。根据是否为百日咳博德特氏菌阳性将病例分为 2 组。比较了百日咳阳性和阴性病例的临床参数、临床严重程度评分和实验室特征。
在 172 名因急性细支气管炎住院的婴儿中，检测到 44 名（25.6%）感染了博德特氏菌，其中 27 名（61.4%）为呼吸道病毒合并感染。在 44 名百日咳阳性婴儿中，仅有 17 名（38.6%）出现阵发性咳嗽，13 名（29.5%）出现痉挛性咳嗽，15 名（34.1%）出现咳嗽后呕吐。入院时，根据 Wang 临床评分，百日咳阳性和阴性婴儿之间没有显著差异（4.9±1.5 vs. 5.2±2.5；p=0.689）。两组的整体疾病严重程度评分也相似（6.5±1.4 vs. 6.9±1.6；p=0.095）。
在因急性细支气管炎住院的婴幼儿中，百日咳博德特氏菌感染很常见，主要与呼吸道病毒合并感染。婴儿百日咳的临床特征不具有特征性。通过临床发现无法区分病毒性细支气管炎和百日咳病例。急性细支气管炎住院婴儿合并百日咳感染不会影响临床结局。
