Yang Qing, Wang Dong-Mei, An Qi, Huang Liang
Department of Science and Education Division, Public Health Clinical Center of Chengdu, Chengdu, Sichuan, China.
Front Pediatr. 2025 Aug 26;13:1455345. doi: 10.3389/fped.2025.1455345. eCollection 2025.
This study aimed to analyze the epidemiological characteristics and clinical features of hospitalized children with pertussis who were admitted to the Chengdu Public Health Clinical Center (CPHCC), China from 2018 to 2023.
We conducted a retrospective, anonymized study in children who were diagnosed with pertussis from January 2018 to December 2023 at the CPHCC. Univariate and multivariate Cox regression and the autoregressive integrated moving average model were used for identifying risk factors, and epidemiological trend analysis was performed.
We analyzed the data of 643 children with pertussis, 351 (54.59%) were younger than 6 months and 344 (53.50%) had a positive contact history. The mean (standard deviation) length of hospital stay was 8.6 (2.8) days. The median (interquartile range) number of days of coughing to the hospitalization time was 15 (12-20). In these patients, the most common clinical manifestations included a cough in 643 (100%), pneumonia in 364 (56.61%), paroxysmal spasmodic cough in 193 (30.02%), pulmonary rales in 175 (27.22%), and hoarseness of voice in 145 (22.55%). The most common complications were cardiomyopathy in 295 (45.88%) patients, liver damage in 255 (39.66%), and bronchopneumonia in 178 (27.68%). Univariate analysis and multivariate Cox proportional hazard model analysis suggested that an older age was beneficial for discharge from hospital ( < 0.05). However, patients who were treated with methylprednisolone and sulfamethoxazole had a longer length of hospital stay (both < 0.05). An older age of onset, heavier weight, and therapeutic use of azithromycin contributed to a shorter length of hospital stay (all < 0.05). A time series analysis showed a stable and predictable increase in pertussis cases.
Heightened clinical and public health focus is needed for children with pertussis, particularly infants younger than 6 months. Public health investments should be increased, and specific measures should be developed to monitor and standardize the management of pertussis through multiple channels to interrupt the large-scale spread of this disease. Clinically, methylprednisolone is not recommended for treating pertussis.
本研究旨在分析2018年至2023年期间在中国成都公共卫生临床中心（CPHCC）住院的百日咳患儿的流行病学特征和临床特点。
我们对2018年1月至2023年12月在CPHCC被诊断为百日咳的患儿进行了一项回顾性、匿名研究。采用单因素和多因素Cox回归以及自回归积分滑动平均模型来识别危险因素，并进行流行病学趋势分析。
我们分析了643例百日咳患儿的数据，其中351例（54.59%）年龄小于6个月，344例（53.50%）有阳性接触史。平均（标准差）住院时间为8.6（2.8）天。咳嗽至住院时间的中位数（四分位间距）为15（12 - 20）天。在这些患者中，最常见的临床表现包括咳嗽643例（100%）、肺炎364例（56.61%）、阵发性痉挛性咳嗽193例（30.02%）、肺部啰音175例（27.22%）、声音嘶哑145例（22.55%）。最常见的并发症是心肌病295例（45.88%）、肝损伤255例（39.66%）、支气管肺炎178例（27.68%）。单因素分析和多因素Cox比例风险模型分析表明，年龄较大有利于出院（<0.05）。然而，接受甲泼尼龙和磺胺甲恶唑治疗的患者住院时间较长（均<0.05）。发病年龄较大、体重较重以及使用阿奇霉素治疗有助于缩短住院时间（均<0.05）。时间序列分析显示百日咳病例呈稳定且可预测的增加。
对于百日咳患儿，尤其是6个月以下的婴儿，需要加强临床和公共卫生关注。应增加公共卫生投入，并制定具体措施，通过多种渠道监测和规范百日咳的管理，以阻断该疾病的大规模传播。临床上，不建议使用甲泼尼龙治疗百日咳。
