Bordetella pertussis in infants hospitalized for acute respiratory symptoms remains a concern

BMC Infectious Diseases

Fabio Midulla²  Stefano Papasso²  Marianna Ferrara²  Enea Bonci²  Paola Papoff²  Corrado Moretti²  Carolina Scagnolari³  Alessandra Pierangeli³  Concetta Schiavariello²  Anna Carannante¹  Paola Stefanelli¹  Raffaella Nenna²  Ambra Nicolai² 

[1]Department of Infectious, Parasitic & Immune-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy

[2]Department of Paediatrics, “Sapienza” University of Rome, Rome, Italy

[3]Molecular Medicine Department, “Sapienza” University of Rome, Rome, Italy

关键词: Vaccine;    Infants;    Bordetella pertussis;    Bronchiolitis;   

Others  :  1145444
DOI  :  10.1186/1471-2334-13-526

 received in 2013-07-08, accepted in 2013-10-30,  发布年份 2013

【 摘 要 】

Background

Preliminary results suggest that pertussis infection might be considered in infants during a seasonal respiratory syncytial virus (RSV) outbreak.

Methods

In order to analyze clinical features and laboratory findings in infants with pertussis hospitalized for acute respiratory symptoms during a seasonal RSV outbreak, we conducted a retrospective single-center study on 19 infants with pertussis (6 boys; median age 72 days) and 19 matched controls (RSV-bronchiolitis), hospitalized from October 2008 to April 2010. B. pertussis and RSV were detected from nasopharyngeal washes with Real Time-PCR.

Results

Infants with pertussis were less often breastfeed than infants with RSV bronchiolitis (63.2% vs 89.5%; p <0.06). Clinically, significantly fewer infants with pertussis than controls had more episodes of whooping cough (63.2% vs 0.0%; p < 0.001) and also less frequently fever at admission (15.8% vs 68.4%; p <0.01), apnea (52.6% vs 10.5%; p <0.006), and cyanosis (52.6% vs 10.5%; p < 0.006). Infants with pertussis had more often no abnormal chest sounds on auscultation than infants with RSV bronchiolitis (0% vs 42,1%; p < 0.005). The absolute blood lymphocyte and eosinophil counts were higher in infants with B. pertussis than in controls with bronchiolitis (23886 ± 16945 vs 10725 ± 4126 cells/mm³, p < 0.0001 and 13.653 ± 10.430 vs 4.730 ± 2.400 cells/mm³, p < 0.001). The molecular analysis of 2 B. pertussis isolates for ptxA1, ptxP3, and prn2 genes showed the presence of gene variants.

Conclusions

When infants are hospitalized for acute respiratory symptoms, physicians should suspect a pertussis infection, seek for specific clinical symptoms, investigate lymphocyte and eosinophil counts and thus diagnose infection early enough to allow treatment.

【 授权许可】

   
2013 Nicolai et al.; licensee BioMed Central Ltd.

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