Tao Yue, Tang Mingyu, Luo Lijuan, Xiang Long, Xia Yijun, Li Biru, Cao Qing, Mo Xi
Department of Infectious Diseases, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.
The Laboratory of Pediatric Infectious Diseases, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.
Ann Transl Med. 2019 Sep;7(18):443. doi: 10.21037/atm.2019.08.85.
In China, pertussis is a major health problem with an increasing incidence despite immunization efforts. Timely and accurate diagnosis is essential for the optimal management of pertussis, especially in severe cases.
Nasopharyngeal swabs or sputum specimens were obtained from patients suspected of having pertussis on the day of hospitalization at Shanghai Children's Medical Center from December 01, 2016, to November 30, 2017. The specimens were tested with the FilmArray Respiratory Panel, a multiplex polymerase chain reaction (PCR) assay that detects 16 viruses, (), (), and ().
Among the 140 children studied, 50.0% (70/140) were detected with a single pathogen, 45.0% (63/140) were detected with multiple pathogens, and 5.0% (7/140) had no detected pathogens. Forty-nine (35%, 49/140) patients tested positive for B. pertussis. Respiratory syncytial virus (RSV), parainfluenza virus (Para) and rhinovirus/enterovirus (Rhino/Entero) were the most prevalent pathogens in patients with pertussis-like syndrome. No significant differences between the groups with pertussis and pertussis-like syndrome were observed regarding the clinical symptoms. Severe cases were more frequently observed in unvaccinated, premature and pertussis/RSV co-infection patients.
Our study highlights the importance of the timely and accurate diagnosis of pertussis based on both clinical symptoms and laboratory methods.
在中国，尽管开展了免疫接种工作，但百日咳仍是一个主要的健康问题，其发病率呈上升趋势。及时准确的诊断对于百日咳的最佳管理至关重要，尤其是在重症病例中。
于2016年12月1日至2017年11月30日期间，在上海儿童医学中心，从疑似患有百日咳的住院患者中获取鼻咽拭子或痰液标本。使用FilmArray呼吸道检测板对标本进行检测，这是一种多重聚合酶链反应（PCR）检测方法，可检测16种病毒、（）、（）和（）。
在研究的140名儿童中，50.0%（70/140）检测出单一病原体，45.0%（63/140）检测出多种病原体，5.0%（7/140）未检测出病原体。49名（35%，49/140）患者百日咳杆菌检测呈阳性。呼吸道合胞病毒（RSV）、副流感病毒（Para）和鼻病毒/肠道病毒（Rhino/Entero）是百日咳样综合征患者中最常见的病原体。在百日咳组和百日咳样综合征组之间，未观察到临床症状有显著差异。未接种疫苗、早产以及百日咳/RSV合并感染的患者中重症病例更为常见。
我们的研究强调了基于临床症状和实验室方法及时准确诊断百日咳的重要性。
