Mihai Cristina Maria, Lupu Ancuta, Chisnoiu Tatiana, Balasa Adriana Luminita, Baciu Ginel, Fotea Silvia, Lupu Vasile Valeriu, Popovici Violeta, Cambrea Simona Claudia, Grigorian Mircea, Suciu Felicia, Enache Florin-Daniel, Sora Anna, Stoicescu Ramona Mihaela
Pediatric Department, Faculty of General Medicine, "Ovidius" University, 900470 Constanta, Romania.
Pediatrics, County Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania.
Antibiotics (Basel). 2025 Apr 23;14(5):428. doi: 10.3390/antibiotics14050428.
Pertussis remains a significant cause of respiratory illness in children, particularly in regions with suboptimal vaccination coverage. This retrospective study analyzes the clinical presentations, co-infections, treatment, and outcomes of pediatric patients diagnosed with at the Constanța County Clinical Emergency Hospital "St. Apostle Andrew" between 1 January and 30 September 2024. Thirty-eight children, predominantly under the age of 3 years (81.58%), were included. Demographic data, clinical features, coinfecting pathogens, antimicrobial regimens, and hospital outcomes were reviewed. Only 7 out of 38 children (18.42%) had received pertussis vaccination, and none benefited from maternal immunization. The highest incidence occurred in infants under 1 year (44.74%). Intensive care was required in 18.42% of cases, and macrolides were the most frequently used antibiotics (68.42%). Co-detection of respiratory pathogens-particularly , enteroviruses, and human rhinoviruses-was common. Severe cases often exhibited hyperleukocytosis, which was associated with complications such as heart failure. These findings underscore the need for timely recognition and management of pertussis and its complications. Although macrolides remain the first-line therapy, adjunctive treatments like leukoreduction may be considered in critical cases. The persistence of pertussis despite vaccination efforts highlights the challenges posed by waning immunity and diagnostic limitations, reinforcing the need for strengthened public health strategies.
百日咳仍然是儿童呼吸道疾病的一个重要病因，尤其是在疫苗接种覆盖率不理想的地区。这项回顾性研究分析了2024年1月1日至9月30日期间在康斯坦察县“圣使徒安德鲁”临床急救医院被诊断为百日咳的儿科患者的临床表现、合并感染、治疗及预后情况。纳入了38名儿童，其中大多数年龄在3岁以下（81.58%）。对人口统计学数据、临床特征、合并感染的病原体、抗菌治疗方案及住院结局进行了回顾。38名儿童中只有7名（18.42%）接种过百日咳疫苗，且没有一例从母体免疫中获益。发病率最高的是1岁以下婴儿（44.74%）。18.42%的病例需要重症监护，大环内酯类是最常用的抗生素（68.42%）。呼吸道病原体（尤其是肺炎支原体、肠道病毒和人鼻病毒）的合并检测很常见。重症病例常表现为白细胞增多症，这与心力衰竭等并发症有关。这些发现强调了及时识别和处理百日咳及其并发症的必要性。尽管大环内酯类仍然是一线治疗药物，但在重症病例中可考虑采用如白细胞去除术等辅助治疗。尽管进行了疫苗接种努力，但百日咳仍然存在，这凸显了免疫减弱和诊断局限性带来的挑战，强化了加强公共卫生策略的必要性。
