College of Medicine, Yeungnam University, Daegu, South Korea.
Department of Internal Medicine, Yeungnam University, Daegu, South Korea.
J Microbiol Immunol Infect. 2021 Aug;54(4):687-692. doi: 10.1016/j.jmii.2020.05.012. Epub 2020 May 28.
Pertussis, is an infectious respiratory disease caused by Bordetella pertussis. The incidence of pertussis has been increasing in South Korea to due to waning vaccine-induced immunity. Culture has a low sensitivity and a long turnaround time (TAT). Recently, a rapid multi-polymerase chain reaction (mPCR) test with a TAT of about 1 h was developed for the detection of respiratory pathogens (17 viruses and three bacteria), including B. pertussis. This study aimed to investigate the effectiveness of mPCR for early diagnosis and treatment of pertussis.
We performed a retrospective study of patients with pertussis diagnosed from May 2017 to June 2019 at a university hospital in South Korea. Nasopharyngeal swab specimens were tested using mPCR. Data were extracted from medical records.
A total of 27 patients with a median age of 48.9 years (range: 3.3-82.2 years) were diagnosed with pertussis, of whom 9 (33.3%) were male. Eleven (40.7%) had fever, 12 (44.4%) had dyspnea, three (11.1%) had paroxysmal cough, and nine (33.3%) had inspiratory whooping. The median interval from symptom onset to diagnosis was 9.0 days (range: 1-31 days). Twenty-four patients (81.5%) were diagnosed within 2 weeks from symptom onset. All but one patient was prescribed macrolide antibiotics. Twenty-two patients (81.5%) required hospitalization, including three (11.1%) who required intensive care unit care for ventilation.
Testing patients with respiratory symptoms using mPCR can improve early diagnosis of pertussis, ensure proper treatment, and may help with outbreak control.
百日咳是由百日咳博德特氏菌引起的传染性呼吸道疾病。由于疫苗诱导的免疫力下降，韩国百日咳的发病率一直在上升。培养的灵敏度低，周转时间（TAT）长。最近，开发了一种快速多重聚合酶链反应（mPCR）检测方法，TAT 约为 1 小时，用于检测呼吸道病原体（包括 B. pertussis 的 17 种病毒和三种细菌）。本研究旨在探讨 mPCR 对百日咳早期诊断和治疗的有效性。
我们对韩国一家大学医院 2017 年 5 月至 2019 年 6 月期间诊断的 27 例百日咳患者进行了回顾性研究。使用 mPCR 检测鼻咽拭子标本。从病历中提取数据。
共诊断出 27 例中位年龄为 48.9 岁（范围：3.3-82.2 岁）的百日咳患者，其中 9 例（33.3%）为男性。11 例（40.7%）有发热，12 例（44.4%）有呼吸困难，3 例（11.1%）有阵发性咳嗽，9 例（33.3%）有吸气性哮鸣。从症状出现到诊断的中位间隔为 9.0 天（范围：1-31 天）。24 例（81.5%）在症状出现后 2 周内确诊。除 1 例外，所有患者均开具大环内酯类抗生素。22 例（81.5%）需要住院治疗，包括 3 例（11.1%）因需要呼吸机通气而入住重症监护病房。
使用 mPCR 对有呼吸道症状的患者进行检测可以提高百日咳的早期诊断，确保适当的治疗，并有助于控制疫情。
