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Pertussis detection in children with cough of any duration.
BMC Pediatr 2019; 19(1):236BPed

Abstract

BACKGROUND

The diagnosis of pertussis in clinical practice continues to be a challenge worldwide as the symptoms are variable. We aimed to determine the prevalence of pertussis in Chinese children irrespective of cough duration and explore the clinical characteristics of children with pertussis with different cough durations.

METHODS

This was a prospective study of children 1 month to 11 years of age with different cough durations in one large Chinese hospital. Bilateral deep posterior nasopharyngeal swabs and venepuncture for full blood count, CRP and serology and sputum were obtained when possible for investigation. E-test strips were used for testing the susceptibility of the B.pertussis isolates against erythromycin, azithromycin, sulphamethoxazole/trimethoprim, levofloxacin, amoxicillin and doxycycline. Demographic, clinical and laboratory information on culture and antimicrobial susceptibility testing was collected from children, and analyzed using SAS v.10 (SAS Institute Inc., USA).

RESULTS

After exclusions we analyzed 312 children. Ninety-seven (31.1%) children had laboratory evidence of pertussis. When grouped by cough duration, few characteristics were significant between children with and without pertussis. Of the 36 isolates, 72.2% (26/36)could not be inhibited by erythromycin and azithromycin at all. The MIC50 and MIC90 to amoxicillin were 0.75 mg/L and 1 mg/L respectively, sensitive to amoxicillin by the EUCAST points.

CONCLUSIONS

The "one-size-fits-all" clinical pertussis case definition is no longer optimal to recognize this disease. A large comprehensive study of children with all types of cough is required to make substantial inroads into increasing both the sensitivity and specificity in pertussis diagnosis, which will have a beneficial impact on public health. Amoxicillin maybe an alternative for children with marolide-resistant B.pertussis infection; however, local sensitivities are required to inform clinical practice.

Authors+Show Affiliations

Beijing Children's Hospital Affiliated to Capital Medical University, No. 56 Nan-Li-Shi Road, Beijing, 100045, China. Department of Respiratory Medicine, Jiangxi Provincial Children's Hospital, Nanchang, China.Department of Respiratory Medicine, Jiangxi Provincial Children's Hospital, Nanchang, China.Beijing Institute of Pediatrics, Beijing Children's Hospital, Beijing, China.Department of Respiratory Medicine, Jiangxi Provincial Children's Hospital, Nanchang, China.Beijing Institute of Pediatrics, Beijing Children's Hospital, Beijing, China.Department of Clinical Laboratory, Jiangxi Provincial Children's Hospital, Nanchang, China.Department of Respiratory Medicine, Jiangxi Provincial Children's Hospital, Nanchang, China.Department of Respiratory Medicine, Jiangxi Provincial Children's Hospital, Nanchang, China.Beijing Children's Hospital Affiliated to Capital Medical University, No. 56 Nan-Li-Shi Road, Beijing, 100045, China. pkkunlingshen@sina.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31299934

Citation

Wu, Dan-Xia, et al. "Pertussis Detection in Children With Cough of Any Duration." BMC Pediatrics, vol. 19, no. 1, 2019, p. 236.
Wu DX, Chen Q, Yao KH, et al. Pertussis detection in children with cough of any duration. BMC Pediatr. 2019;19(1):236.
Wu, D. X., Chen, Q., Yao, K. H., Li, L., Shi, W., Ke, J. W., ... Shen, K. L. (2019). Pertussis detection in children with cough of any duration. BMC Pediatrics, 19(1), p. 236. doi:10.1186/s12887-019-1615-3.
Wu DX, et al. Pertussis Detection in Children With Cough of Any Duration. BMC Pediatr. 2019 Jul 12;19(1):236. PubMed PMID: 31299934.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pertussis detection in children with cough of any duration. AU - Wu,Dan-Xia, AU - Chen,Qiang, AU - Yao,Kai-Hu, AU - Li,Lan, AU - Shi,Wei, AU - Ke,Jiang-Wei, AU - Wu,Ai-Min, AU - Huang,Peng, AU - Shen,Kun-Ling, Y1 - 2019/07/12/ PY - 2019/02/24/received PY - 2019/07/04/accepted PY - 2019/7/14/entrez PY - 2019/7/14/pubmed PY - 2019/7/14/medline KW - Characteristics KW - Children KW - Prevalence KW - Whooping cough SP - 236 EP - 236 JF - BMC pediatrics JO - BMC Pediatr VL - 19 IS - 1 N2 - BACKGROUND: The diagnosis of pertussis in clinical practice continues to be a challenge worldwide as the symptoms are variable. We aimed to determine the prevalence of pertussis in Chinese children irrespective of cough duration and explore the clinical characteristics of children with pertussis with different cough durations. METHODS: This was a prospective study of children 1 month to 11 years of age with different cough durations in one large Chinese hospital. Bilateral deep posterior nasopharyngeal swabs and venepuncture for full blood count, CRP and serology and sputum were obtained when possible for investigation. E-test strips were used for testing the susceptibility of the B.pertussis isolates against erythromycin, azithromycin, sulphamethoxazole/trimethoprim, levofloxacin, amoxicillin and doxycycline. Demographic, clinical and laboratory information on culture and antimicrobial susceptibility testing was collected from children, and analyzed using SAS v.10 (SAS Institute Inc., USA). RESULTS: After exclusions we analyzed 312 children. Ninety-seven (31.1%) children had laboratory evidence of pertussis. When grouped by cough duration, few characteristics were significant between children with and without pertussis. Of the 36 isolates, 72.2% (26/36)could not be inhibited by erythromycin and azithromycin at all. The MIC50 and MIC90 to amoxicillin were 0.75 mg/L and 1 mg/L respectively, sensitive to amoxicillin by the EUCAST points. CONCLUSIONS: The "one-size-fits-all" clinical pertussis case definition is no longer optimal to recognize this disease. A large comprehensive study of children with all types of cough is required to make substantial inroads into increasing both the sensitivity and specificity in pertussis diagnosis, which will have a beneficial impact on public health. Amoxicillin maybe an alternative for children with marolide-resistant B.pertussis infection; however, local sensitivities are required to inform clinical practice. SN - 1471-2431 UR - https://www.unboundmedicine.com/medline/citation/31299934/Pertussis_detection_in_children_with_cough_of_any_duration L2 - https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-019-1615-3 DB - PRIME DP - Unbound Medicine ER -