Zeng X Y, Chen B Q, Ma H, Wang L, Xu X M, Wang H, Zeng M
Department of Infectious Diseases, Children's Hospital of Fudan University, Anhui Provincial Children's Hospital, Hefei 230051, China.
Department of Infectious Disease,Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 200032, China.
Zhonghua Er Ke Za Zhi. 2025 Aug 2;63(8):852-857. doi: 10.3760/cma.j.cn112140-20250326-00256.
To analyze the epidemiological and clinical characteristics of pertussis in children and the antimicrobial resistance pattern of isolates in Anhui province in 2024. Prospective observational study. The demographic information of 4 233 cases of pertussis confirmed by nucleic acid testing in Anhui Provincial Children's Hospital in 2024 and the clinical data of hospitalized cases were collected. The annual epidemic trend of pertussis in children, the clinical characteristics of hospitalized cases, and the vaccination status were analyzed. isolates were recovered from nasopharyngeal swabs obtained from hospitalized children and their family caregivers during the outbreak period and antimicrobial susceptibility was tested. Among the 4 233 children, 2 330 were male and 1 903 were female. A total of 4 059 cases (95.9%) occurred from March to September, with the peak of the disease from April to July (3 364 cases (79.5%)).There were 4 075 cases (96.3%) aged 9 years and under, among which 718 cases (17.0%) were under 1 year old and 2 494 cases (58.9%) were aged 4 to 7 years. During the outbreak period, there were a total of 301 hospitalized children (7.1%), with an average age of 4.4 (2.8, 16.5) months. Among them, 61 cases (20.3%) received the full course of vaccination (4 doses), 64 cases (21.3%) received partial doses of the vaccine, and 176 cases (58.5%) were unvaccinated. Among the unvaccinated children, 79.6% (172/216) were under 1 year old, 8.7% (2/23) were between 1 and 3 years old, and 3.2% (2/62) were 3 years old or older. None of the 20 cases (6.6%) of severe pertussis received pertussis vaccine.Among the 301 hospitalized children, 298 cases (99.0%) presented with typical paroxysmal spasmodic cough, 94 cases (31.2%) had vomiting after coughing, 82 cases (27.2%) had whooping sounds, and 54 cases (17.9%) had cyanotic attacks. There were 228 cases (75.7%) complicated with pneumonia and 5 cases (1.7%) with pertussis encephalopathy. The infection rate among the accompanying family members who underwent screening was 77.1% (371/481). Based on the minimum inhibitory concentration testing of 186 isolates, the minimum inhibitory concentration 90 of azithromycin and trimethoprim-sulfamethoxazole were >256.000 and 0.050 mg/L, respectively. The peak of pertussis cases in Anhui region in 2024 occurred from April to July. Children aged ≤9 years were the major affected population. Infants and preschool children were most susceptible to pertussis. The intrafamily transmission rate of pertussis is high. Empirical use of macrolides for the treatment of pertussis is not recommended. Trimethoprim-sulfamethoxazole can be used as the preferred antibiotic for pertussis in children aged 2 months and above.
分析2024年安徽省儿童百日咳的流行病学和临床特征以及分离株的抗菌药物耐药模式。前瞻性观察性研究。收集2024年安徽省儿童医院4233例经核酸检测确诊的百日咳病例的人口统计学信息和住院病例的临床资料。分析儿童百日咳的年度流行趋势、住院病例的临床特征以及疫苗接种情况。在疫情期间从住院儿童及其家庭照顾者的鼻咽拭子中分离出菌株并进行抗菌药物敏感性检测。4233名儿童中，男性2330名，女性1903名。共有4059例（95.9%）发生在3月至9月，4月至7月为发病高峰（3364例（79.5%））。9岁及以下儿童有4075例（96.3%），其中1岁以下718例（17.0%），4至7岁2494例（58.9%）。疫情期间，共有301名住院儿童（7.1%），平均年龄4.4（2.8，16.5）个月。其中，61例（20.3%）完成全程疫苗接种（4剂），64例（21.3%）接种部分剂量疫苗，176例（58.5%）未接种疫苗。未接种疫苗的儿童中，1岁以下占79.6%（172/216），1至3岁占8.7%（2/23），3岁及以上占3.2%（2/62）。20例（6.6%）重症百日咳患儿均未接种百日咳疫苗。301名住院儿童中，298例（99.0%）表现为典型的阵发性痉挛性咳嗽，94例（31.2%）咳嗽后呕吐，82例（27.2%）有鸡鸣样吼声，54例（17.9%）有青紫发作。228例（75.7%）并发肺炎，5例（1.7%）并发百日咳脑病。接受筛查的陪同家庭成员感染率为77.1%（371/481）。基于186株菌株的最低抑菌浓度检测，阿奇霉素和复方磺胺甲恶唑的最低抑菌浓度90分别>256.000和0.050mg/L。2024年安徽地区百日咳病例高峰出现在4月至7月。≤9岁儿童是主要受影响人群。婴幼儿和学龄前儿童最易感染百日咳。百日咳家庭内传播率高。不建议经验性使用大环内酯类药物治疗百日咳。复方磺胺甲恶唑可作为2个月及以上儿童百日咳的首选抗生素。
