Mahmoudi Shima, Banar Maryam, Pourakbari Babak, Alavi Hediyeh Sadat, Eshaghi Hamid, Ahari Alireza Aziz, Mamishi Setareh
Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Prague Med Rep. 2018;119(1):61-69. doi: 10.14712/23362936.2018.6.
The aim of this study was to recognize the identity and frequency of etiologic agents of the pertussis-like syndrome in children < 2 years of age. A cross-sectional hospital-based study conducted from August 2014 to August 2015. All children < 2 years of age (n=100) who were suspected as pertussis infected were enrolled in this study and tested for Bordetella pertussis, adenovirus (Adv), respiratory syncytial virus (RSV), human metapneumovirus (hMPV), and influenza virus A (INF-A) by real-time PCR technique. RSV was the most detected pathogen (20%), followed by B. pertussis (18%), Adv (16%), INF-A (11%), and hMPV (10%). Co-infection was observed in 8 patients (11%) and the combinations of RSV/INF-A (n=3, 4%), and AdV/B. pertussis (n=3, 4%) were more frequent. RSV, B. pertussis, and hMPV were more frequent pathogens among infants < 4 months of age. However, Adv and INF-A were more frequent pathogens among children > 6 months of age. In this study, RSV was the most frequent identified pathogen (n=20, 20%), followed by B. pertussis (n=18, 18%) and AdV (n=16, 16%). Pertussis was more frequent in spring (8%) and summer (6%). In addition, clinical symptoms of pertussis were the same as some viral pathogens, which can lead to misdiagnosis of infection. Therefore, diagnosis of pertussis should be established on the bases of both the clinical symptoms and the laboratory methods.
本研究的目的是确定2岁以下儿童百日咳样综合征的病原体种类及感染频率。这是一项于2014年8月至2015年8月在医院开展的横断面研究。所有疑似感染百日咳的2岁以下儿童（n = 100）均纳入本研究，并通过实时PCR技术检测百日咳博德特氏菌、腺病毒（Adv）、呼吸道合胞病毒（RSV）、人偏肺病毒（hMPV）和甲型流感病毒（INF-A）。RSV是检测到的最常见病原体（20%），其次是百日咳博德特氏菌（18%）、Adv（16%）、INF-A（11%）和hMPV（10%）。8名患者（11%）存在合并感染，其中RSV/INF-A组合（n = 3，4%）和Adv/百日咳博德特氏菌组合（n = 3，4%）更为常见。RSV、百日咳博德特氏菌和hMPV在4个月以下婴儿中是更常见的病原体。然而，Adv和INF-A在6个月以上儿童中是更常见的病原体。在本研究中，RSV是最常鉴定出的病原体（n = 20，20%），其次是百日咳博德特氏菌（n = 18，18%）和Adv（n = 16，16%）。百日咳在春季（8%）和夏季（6%）更为常见。此外，百日咳的临床症状与一些病毒病原体相同，可能导致感染的误诊。因此，百日咳的诊断应基于临床症状和实验室方法。
