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The outbreak of SARS-CoV-2 in December 2019 in China quickly spread to the rest of the world. By March 2020, the World Health Organization declared the COVID-19 pandemic, and several mitigation strategies were implemented worldwide, highlighting social distancing, quarantine and the use of face masks. Since then, many studies have reported the impact of these interventions on the occurrence of other infectious diseases, especially bacterial infectious diseases disseminated through airborne. Invasive infections with respiratory bacterial pathogens, such as Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Bordetella pertussis, Chlamydia pneumoniae and Mycoplasma pneumoniae have had a marked decline in several countries of the world. Low- and middle-income (LMIC) and high-income countries (HIC) were at different seasons of the year when COVID-19 started and interventions were implemented, but long-lasting consequences of seasonal differences are yet to be elucidated. In this session, we aim to describe the impact of COVID-19 and related intervention strategies in bacterial infectious diseases between LMIC and HIC;determine whether and how the onset of COVID-19 pandemic has changed the broader scenario of infectious diseases;and envision future and emerging infectious diseases in the post-pandemic world.Copyright © 2023
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The objective of this study was to compare the performances of BioFire Respiratory Panel 2 (RP2) plus, quantitative real-time PCR (qPCR), and culture for the detection of Bordetella pertussis in nasopharyngeal swab (NPS) specimens. Consecutive NPS specimens were collected from patients with clinically suspected pertussis from 1 March 1 to 31 July 2018 in Shenzhen Children's Hospital. All the specimens were tested in parallel by RP2 plus, qPCR, and culture methods. A total of 464 children were enrolled in this study. The positive pertussis rates of culture, RP2 plus, and qPCR were 23.1%, 39.0%, and 38.4%, respectively. Compared to the combined reference standard, the sensitivity, specificity, positive predictive value, and negative predictive values were, respectively, 56.6% (95% confidence interval [CI], 49.2 to 63.7%), 100% (98.3 to 100%), 100% (95.7 to 100%), and 77.0% (72.2 to 81.2%) for culture, 89.9% (84.5 to 93.7%), 96.0% (92.8 to 97.9%), 93.9% (89.1 to 96.8%), and 93.3% (89.5 to 95.8%) for RP2 plus, and 86.8% (80.9 to 91.1%), 94.9% (91.4 to 97.1%), 92.1% (86.9 to 95.5%), and 91.3% (87.2 to 94.2%) for qPCR. The most prevalent codetected pathogen was human rhinovirus/enterovirus (n = 99, 52.4%), followed by parainfluenza virus (n =32, 16.9%) and respiratory syncytial virus (n = 29, 15.3%), in children with B. pertussis present, which was consistent with the top three pathogens previously found in children with B. pertussis absent. Turnaround times for RP2 plus, qPCR, and culture were 2 h, 8 h, and 120 h, respectively. RP2 plus quickly and accurately detected B. pertussis, providing valuable information for an early clinical diagnosis and optimal choice of therapy. IMPORTANCE In recent years, there have been some epidemic or local outbreaks of pertussis in countries with high vaccination rates. One of the crucial factors in controlling pertussis is early diagnosis, which is based on specific laboratory measurements, including culture, serological tests, and PCR assays. Compared to culture and serological tests, PCR is more suitable for clinical application, with a fast detection speed of several hours independent of the disease stage and individual vaccination status. BioFire Respiratory Panel 2 plus, a multiplex PCR assay for simultaneously detecting 22 respiratory pathogens, facilitates the quick detection of Bordetella pertussis and coinfecting respiratory pathogens. It also provides valuable information for an early clinical diagnosis and optimal choice of therapy for children with clinically suspected pertussis.
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Respiratory Syncytial Virus, Human , Whooping Cough , Humans , Child , Whooping Cough/diagnosis , Bordetella pertussis/genetics , Nasopharynx , Multiplex Polymerase Chain Reaction/methodsABSTRACT
This article discusses the worldwide routine vaccination coverage in 2021, as part of the Immunisation Agenda 2030, a global immunisation strategy to reduce morbidity and mortality from vaccine-preventable diseases. The report presents global, regional, and national estimates and trends in vaccination coverage through 2021, based on reviews of country-specific data, including administrative and survey-based coverage. Global estimates show that coverage with 3 doses of diphtheria, tetanus and pertussis-containing vaccine (DTPcv3) and the first dose of measles-containing vaccine (MCV1) decreased to their lowest levels since 2008. In 2021, 25.0 million infants were not vaccinated with DTPcv3, 2.1 million more than in 2020, and 5.9 million more than in 2019. The number of zero-dose children was 37% higher than in 2019, with 18.2 million infants not receiving any DTPcv dose by the age of 12 months. The report highlights that the full recovery from disruptions to immunisation programmes due to the COVID-19 pandemic will require context-specific strategies to find missed children, prioritise essential health services, and strengthen immunisation programmes to prevent outbreaks.
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Introduction: Vaccination against Bordetella pertussis is recommended by the Italian Ministry of Health starting from the 28th week of pregnancy. However, data about vaccine coverages are unknown and sharing good practices is necessary to increase adherence to vaccine programs implemented at local level. Here we present data on epidemiology and vaccine coverage of Pertussis in Tuscany from 2012 to 2021 and data on Pertussis vaccine coverage in pregnant women in the Health District of urban area of Pisa for the period 2017 to September 2022. Materials and methods: Data on pertussis cases and pertussis vaccine coverage were retrieved form the Regional Health Agency that made available data on Infectious Diseases Epidemiology in Tuscany on a public report. The diphteria, tetanus, pertussis (dTpa) vaccination in pregnant women were extracted from the vaccination registry from 2017 to 30 September 2022 and adjusted new births from 1st April to 30th March of the following year were considered as denominator. For the current year we assumed that the monthly trend of the absolute number of vaccinations is maintained (+45.3 vaccinations/month) and that the number of new-borns is the same as in 2021. Results: In Tuscany, a progressive increase in the number of cases has been observed since 2012, peaking in 2017 with 115 infections concentrated mainly in children under one year of age. After a significant reduction in the three-year period 2018-2020, with values between 25 and 39 infections per year, no cases of the disease were notified in 2021. Most likely due to the actions taken to counteract the transmission of SARS-CoV-2. Notably, from 2017 to 30 September 2022, a significant increase in vaccination coverage for dTpa in pregnant women was observed, with an average annual increase from 2018 onwards of 39% (range 18%-63%). Discussion and conclusions: Even if the vaccine coverage calculation has some limitations, the availability of a free access services for pregnant women and their contacts has improved adherence to the vaccination against pertussis. However, to achieve an active recruitment strategic to overcome cultural, linguistic and hesitancy barriers it is crucial to improve active call of the pregnant women.
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Vaccination is effective in preventing the increase of disease, especially emerging infectious diseases (EIDs), and it is particularly important for people in close contact with infected sources and susceptible populations who are at increased risk of getting infectious diseases due to behavior, occupation or health. Despite targeted vaccination guidelines, inadequate vaccination of the key populations fails to receive widespread attention, resulting in a high-risk transition of disease from key populations to general populations. Strengthening the vaccination of the susceptible groups can effectively block the spread of pathogens to general populations, and reduce the consumption of medical resources in universal vaccination, which has significant economic value. In this review, we describe the prevalence of EIDs, analyze the experience and lessons of infectious disease vaccination in key populations through several cases, and further explore the causes for the decline in vaccination rates of key populations. According to the trends of EIDs, a plan to strengthen the vaccination of key populations is proposed to effectively prevent the transition of EIDs from key populations to general populations.
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Objective: To understand the pathogenic spectrum and epidemiological characteristics of severe acute respiratory infection (SARI) in adult inpatients in Yangpu District, Shanghai, China, in order to explore strategies for the prevention and treatment of respiratory infectious diseases. Methods: Individual cases were from adult inpatients with SARI in Yangpu District, Shanghai, China from January 2019 to July 2021. Their respiratory samples were collected for etiological pathogen testing. Results: A total of 681 SARI cases were enrolled for sampling and lab testing. Among them, 79.00% were aged 60 years and older, and 75.48% had confirmed chronic disease history. A total of 163 infection inpatients (23.94%) were positive for at least one pathogen. The pathogens identified most frequently were influenza A virus (6.75%), followed by rhinovirus/enterovirus (3.23%), parainfluenza virus (PIV) (2.79%), Mycoplasma pneumoniae (2.35%), coronavirus (CoV) (2.06%). The positive rates of adenovirus (AdV), human metapneumovirus (hMPV), respiratory syncytial virus and bocavirus were all less than 2%. Bacterial strains were identified in eleven SARI cases, including Staphylococcus aureus and Pseudomonas aeruginosa (4 strains), Klebsiella pneumoniae (3 strains). Legionella pneumophila was detected in 9 cases (1.32%) and Bordetella pertussis in 5 cases (0.73%). Two pathogens were co-detected from 11 cases, accounting for 1.62% of 163 positive cases. The most common co-detected pathogens were influenza A virus and other pathogens, accounting for 54.55% of the mixed infection. The positive rates of pathogens were not significantly different between less than 60 years old and over 60 years old groups except for Bordetella pertussis, adenovirus and Mycoplasma pneumonia(P < 0.05). Influenza virus had epidemic peak in winter and spring, but not in summer from 2019 to 2021. Conclusion: Various respiratory pathogens are detected from adult SARI cases. It is mainly influenza virus, with co-detected pathogens and rare pathogens. This study provides helpful information for targeted prevention and control measures including vaccination.
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This report, which updates previous reports, presents estimates of global, regional, and national vaccination coverage and trends as of 2020. It describes the changes in vaccination coverage and the numbers of unvaccinated and undervaccinated children as measured by receipt of the first and third doses of diphtheria, tetanus, and pertussis-containing vaccine (DTP)in 2020, when the COVID-19 pandemic began, compared with 2019. Global coverage estimates with the third dose of DTP (DTP3) and a polio vaccine (Pol3) fell from 86% in 2019 to 83% in 2020. Similarly, MCV1 coverage fell from 86% in 2019 to 84% in 2020. The last year the coverage estimates were at 2020 levels was 2009 for DTP3 and 2014 for both MCV1 and the third dose of Pol (Pol3). Worldwide, 22.7 million children(17% of the target population) did not receive DTP in 2020, compared with 19.0 million (14%) in 2019. Children who did not receive the first DTP dose (DTP1) by age 12 months (zero-dose children) accounted for 95%of the increased number. Among those who did not receive DTP3 in 2020, approximately 17.1 million (75%)were zero-dose children. Global coverage decreased in 2020 compared with 2019 estimates for the completion of Haemophilus influenzae type b (Hib), hepatitis B vaccine (HepB), human papillomavirus vaccine (HPV),and rubella-containing vaccine (RCV). To reach full coverage with all recommended vaccines, tailored strategies will be needed, especially to reach communities with a lot of children who haven't had any or enough vaccines.
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Background: Infections occur with up to twofold increased risk in patients with monoclonal gammopathy of undetermined significance (MGUS) and tenfold increased risk in multiple myeloma (MM). To reduce risk, revaccination following autologous hematopoietic cell transplantation (AHCT) is recommended to restore humoral immunity. We have previously shown that vaccine titers after AHCT have prognostic significance. In the COVID era, reliable clinical data about antibody titers is relevant yet scarce. We investigated the significance of different vaccine titers in newly diagnosed patients in different stages of the disease. Methods: The study population comprised of 77 patients with MGUS, smoldering multiple myeloma (SMM) and MM who were seen at a tertiary cancer center from 2018- 2022. All patients had antibody titers (B. pertussis, Diptheria, H. Influenzae B, Hepatitis, Influenza, Meningitis, Mumps, Rubeola, Rubella, Poliovirus, S. pneumoniae, Varicella Zoster and Tetanus) tested at the time of diagnosis, prior to start of treatment if indicated. Titers were interpreted in accordance with the manufacturers' recommendations. Patient characteristics were compared using the Kruskal- Wallis and Fisher's exact tests. Associations with % titer positivity were evaluated using the Kruskal- Wallis test. Results: There was significant difference in antibody titer positivity between the different patient groups (51.4% in MGUS, 40.5% in SMM and 34.2% in MM) (p < 0.001). There was no difference in antibody titer positivity depending on age, sex or race. Among individual pathogens, there was a significant difference between the three groups in regards to titers for Diphtheria, Mumps, Poliovirus 3, Strep pneumoniae 19, Strep pneumoniae 56 and Varicella Zoster. Conclusions: Antibody titers for vaccine preventable diseases are significantly different between patients with MGUS, SMM and MM at the time of diagnosis, with MGUS having the highest and MM having the lowest positivity. Patient related factors such as age, sex or race were not associated with antibody titer positivity. Current guidelines for revaccination are not extended to patients with MGUS and SMM and can be considered in prospective trials.
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Objective To assess the risk of public health emergencies, both the indigenous ones and the imported ones, which might occur in the mainland of China in April 2022. Methods An internet based expert counsel was conducted to analyze the surveillance data of public health emergencies and priority communicable diseases in China reported through different channels, and the experts in all provincial centers for disease control and prevention attended this video conference. Results It is expected that number of domestically reported public health emergency events other than COVID-19 in April would remain unchanged from March. The risk of domestic COVID-19 outbreaks caused by the indigenous transmission and the foreign importation is high, making it more difficult to prevent and control the epidemic. Local governments need to strengthen epidemic prevention and control in accordance with national requirements and hold the bottom line of no large-scale rebound of the epidemic. The number of pertussis cases will maintain rising trend due to the improvement of laboratory testing technology, the weakening of vaccine protection and the strengthening of surveillance in some districts. Conclusion Special attention should be paid to COVID-19. General attentions should be paid to pertussis.
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Social restrictions effectively interrupted the typical respiratory virus circulation. The aim of this report is to describe how atypical pneumonia bacteria detections have changed during the COVID-19 pandemic in Finnish children. Bordetella pertussis, Chlamydia pneumoniae, and Mycoplasma pneumoniae findings were gathered from the National Infectious Diseases Register from 2015 to 2021 and stratified into three age groups (0-4, 5-9, and 10-14 years). Incidences per 100,000 children were calculated and 2020 and 2021 was compared to the mean incidence of reference years (2015-2019) by incidence rate ratios. B. pertussis incidence was 32% lower in 2020 and 88% lower in 2021 compared to reference years. C. pneumoniae detections decreased rapidly in 2020 and not a single detection of C. pneumoniae was reported to the register in 2021. M. pneumoniae incidence was 72% lower in 2020 and 89% lower in 2021 than in the reference years. All these findings were seen in all age groups. As the incidences of B. pertussis, C. pneumoniae, and M. pneumoniae detections have been low throughout the pandemic, it seems that the social restrictions have been effective in preventing the spreading of these respiratory bacteria in children. Supplementary Information: The online version contains supplementary material available at 10.1007/s42399-022-01251-9.
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Background: In early March 2020, coronavirus disease (COVID-19), an infectious disease caused by a novel coronavirus, was declared a pandemic by the World Health Organization. Since its emergence and global spread, the pandemic has been one of the greatest global crises in modern human history. Notably, in Sub-Saharan Africa (SSA), COVID-19-related burden and outcomes have been generally lower than many other parts of the world and substantially better than were initially feared. At the same time, there has been great heterogeneity in COVID-19 burden and outcomes between countries in the region, with some reporting particularly high incidence and death figures compared to others. What accounts for the significant cross-country variability apparent in SSA and why have some countries performed better than others? The present study investigates country-specific factors that may help to explain differences in COVID-19 outcomes across 48 countries in SSA.
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Introduction: Indonesia reported the first case of COVID-19, the coverage of routine immunization to prevent diseases in children such as measles, rubella, and diphtheria is decreasing. For example, diphtheria, pertussis and tetanus (DPT3) and measles and rubella (MR1) immunization coverage rates were reduced by more than 35% in May 2020 compared to the same time period in the previous year.
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OBJECTIVE: To establish an agile discovery method of drugs or natural products for epidemics (aCODE) for the development of anti-infectious disease drugs. METHODS: Five infectious diseases (HIV infection, human influenza, Paramyxoviridae infections, bacterial infections and whooping cough) involving more than 40 drugs approved by the United States Food and Drug Administration (FDA) were selected. An experimental group and two negative control groups (A and B) for each disease were set up. The experimental group randomly selected (500 times) M FDA-approved indications as seed drugs for the disease, while negative control group A used all FDA-approved infectious drugs for non-current diseases instead of seed drugs, and negative control group B used all non-infectious disease drugs for non-infectious diseases instead of seed drugs. M ranged from 2 to 20, the target gene information of the seed drug was input, and the feature vector of the seed drug set was calculated. Candidate compounds were predicted through similarity search of drug feature vectors. The size of the inter- section between the predicted drug and the positive set of drugs approved by the FDA for the disease, and the significance of the intersection were calculated. After the establishment of the aCODE method, four drugs (lopinavir, ribavirin, ritonavir and chloroquine) were selected as seed drugs for COVlD-19 to predict the composition of natural products. Using natural products with known anti-coronavirus activities as the verification set, the significance of the prediction results was calculated. RESULTS: In the case of the five infectious diseases, the proportion of positive drugs in the results of prediction in the experimental group increased with the number of seed drugs, while the positive rate of the two negative control groups remained basically unchanged or somewhat trended down. The aCODE method, when applied to COVlD-19 drug screening, could effectively predict drugs with potential anti-SARS-Cov-2 activity (P=0.0046). CONCLUSION: With the aCODE method, the more the seed drugs, the more accu- rate the characteristics of the disease-related gene modules calculated from this group of seed drugs, and the higher the proportion of positive drugs in the prediction result. This method may contribute to the discovery of drugs for COVID-19.
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According to official data published by the World Health Organization (WHO) and UNICEF, 23 million children did not receive basic vaccines through routine immunisation services in 2020, 3.7 million more than in 2019. This latest set of official worldwide childhood immunisation figures, the first to reflect global service disruptions due to COVID-19, show the majority of countries last year experienced drops in childhood vaccination rates. The WHO and UNICEF data highlights disruptions to immunisation services were widespread in 2020, with the WHO Southeast Asian and Eastern Mediterranean regions most affected. As access to health services and immunisation outreach were curtailed, the number of children not receiving their first vaccinations increased in all regions. When compared with 2019, 3.5 million more children missed their first dose of diphtheria, tetanus and pertussis vaccine (DTP-1), while three million more children did not receive their first measles dose.
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Introdução: Os agentes da etiológicos da coqueluche, difteria e cólera são responsáveis por milhares de morte toda ano, segundo OMS estima se que no período de 2020 e 2021 essas mortes aumentaram consideravelmente devido a baixa cobertura vacinal, principalmente causada pela pandemia de Covid-19 e também pelos movimentos anti vacinas. Destaca-se o aumento de difteria em diversos países de América Latina, principalmente na Venezuela e Haiti, surtos de cólera tem sido uma constância na África e o ressurgimento da coqueluche já um fato em diversos países, mesmo com uma boa cobertura vacinal. Objetivo: Identificar os principais epítopos da Bordetella pertussis, Corynebacterium diphtheriae e Vibrio cholerae para o desenvolvimentos de insumos em saúde, contribuindo assim para o aperfeiçoamento de vacinas e o desenvolvimento de novos métodos diagnóstico. Métodos: : As sequências completas das proteínas foram obtidas do SWISSPROT e Tr-EMBL (http://www.expasy.ch). Após a identificação dos epítopos, um alinhamento múltiplo (programa ClustalW) foram realizados para identificar possíveis sequências peptídicas semelhantes depositadas em banco de dados. A síntese de bibliotecas peptídicas foi realizada em sintetizador (Spot Synthesis-ASP222). Foram identificados os epitopos IgM e IgG. Foram comparados testes de Elisa existente no mercado com teste Elisa padronizado utilizando os epítopos mais imunodominates de cada agente etiológicos identificados. Resultados: Na Bordetella pertussis 24 epítopos foram identificados na toxina pertussis e 25 epítopos da pertactina. Na Corynebacterium diphtheriae foram identificados 20 epítopos na toxina diftérica. Na enterotoxina da cólera foram identificaram 14 epítopos ne três proteínas testadas. Os testes de Elisa padronizados para coqueluche e difteria apresentaram uma sensibilidade de 99% e uma especificidade de 100%. Conclusão: Nestes estudos identificamos todos os epítopos B lineares dos imunógenos da toxina pertussis, pertactina, toxina da difteria e enterotoxina da cólera. A identificação e o mapeamentos dos epítopos poderão contribuir para o desenvolvimento de métodos de diagnósticos mais eficientes. Resultados desses trabalhos também poderão contribuir para entendermos o processo de imunização e o aperfeiçoamento de vacinas para que sejam mais eficientes e menos reatogências.
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The Global Pertussis Initiative (GPI) Roundtable Meeting held in 2019, which preceded the COVID-19 pandemic, focused on the incidence, surveillance, and immunization practices for pertussis in the Asian region. Participants from China, India, Indonesia, Malaysia, Pakistan, Philippines, South Korea, Taiwan, and Thailand presented country-specific information on pertussis prevalence, diagnosis, surveillance, vaccine administration and schedules, maternal and neonatal disease rates, and policies and practice of vaccination during pregnancy. In recent years, many Asian countries have seen an increase in pertussis cases, although underreporting of the disease is a concern. Currently, most Asian countries have only passive surveillance for pertussis in place. There is a need for improved surveillance to determine the disease burden and justify vaccination policies and recommendations, such as essential vaccination, boosters, and vaccination during pregnancy. Better awareness of the disease in adolescents and adults is necessary, and infant and childhood vaccination schedules need to be improved in many countries. Differences between private versus public sector vaccination schedules and between whole-cell and acellular pertussis vaccines should continue to be examined. It can be anticipated that unmet needs in the prevention and management of pertussis will continue as the COVID-19 pandemic evolves and that key recommendations highlighted in this meeting report will be of ongoing importance.
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COVID-19 , Whooping Cough , Adolescent , Female , Humans , Infant , Pandemics , Pertussis Vaccine , Pregnancy , SARS-CoV-2 , Thailand , Vaccination , Whooping Cough/epidemiology , Whooping Cough/prevention & controlABSTRACT
Complement, contact activation, coagulation, and fibrinolysis are serum protein cascades that need strict regulation to maintain human health. Serum glycoprotein, a C1 inhibitor (C1-INH), is a key regulator (inhibitor) of serine proteases of all the above-mentioned pathways. Recently, an autotransporter protein, virulence-associated gene 8 (Vag8), produced by the whooping cough pathogen, Bordetella pertussis, was shown to bind to C1-INH and interfere with its function. Here, we present the structure of the Vag8-C1-INH complex determined using cryo-electron microscopy at a 3.6-Å resolution. The structure shows a unique mechanism of C1-INH inhibition not employed by other pathogens, where Vag8 sequesters the reactive center loop of C1-INH, preventing its interaction with the target proteases.IMPORTANCE The structure of a 10-kDa protein complex is one of the smallest to be determined using cryo-electron microscopy at high resolution. The structure reveals that C1-INH is sequestered in an inactivated state by burial of the reactive center loop in Vag8. By so doing, the bacterium is able to simultaneously perturb the many pathways regulated by C1-INH. Virulence mechanisms such as the one described here assume more importance given the emerging evidence about dysregulation of contact activation, coagulation, and fibrinolysis leading to COVID-19 pneumonia.
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Bacterial Proteins/metabolism , Bordetella pertussis/pathogenicity , Complement C1 Inhibitor Protein/metabolism , Immune Evasion , Bacterial Proteins/chemistry , Bacterial Proteins/genetics , Binding Sites , Blood Coagulation , Bordetella pertussis/chemistry , Bordetella pertussis/metabolism , Complement C1 Inhibitor Protein/chemistry , Complement System Proteins/metabolism , Cryoelectron Microscopy , Fibrinolysis , Models, Molecular , Mutation , Protein Binding , Protein Domains , Type V Secretion Systems/genetics , Type V Secretion Systems/metabolism , Virulence , Virulence Factors, BordetellaABSTRACT
INTRODUCTION: There is some evidence that Bordetella pertussis (B. pertussis) can co-infect with viral respiratory infections in young infants. METHODS: B. pertussis infection was studied by culture, polymerase chain reaction (PCR), and loop-mediated isothermal amplification (LAMP) from nasopharyngeal swabs (NPSs) in 49 infants < 12 months of age, who were admitted for lower respiratory tract infections during the winter season. Seven other possible viral pathogens were documented by antigen detection or PCR in NPSs. The clinical feature of infants with mixed infection of B. pertussis and respiratory viruses were examined. RESULTS: Overall, B. pertussis infection was found in 10 (20.4%) cases, nine were less than 6 months of age and seven were unvaccinated. Viral etiology was found in 41 (84%) cases and pertussis-viral co-infection was present in eight patients, five of whom had mixed infection with respiratory syncytial virus. Only the presence of staccato coughing, cyanosis, and lymphocytosis were significantly different in B. pertussis-positive cases compared with B. pertussis-negative cases. Of the 10 pertussis cases, only the culture-positive cases showed the typical symptoms and laboratory findings of pertussis in addition to virus-associated respiratory symptoms with severe hospital course, whereas cases identified as DNA-positive lacked the characteristics of pertussis and their clinical severities were the same as B. pertussis-negative cases. CONCLUSION: In the absence of typical paroxysmal cough and lymphocytosis, we should carefully consider diagnosis of pertussis in young children hospitalized for presumed viral respiratory illness according to local epidemiological surveillance.
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Respiratory Tract Infections , Whooping Cough , Bordetella pertussis/genetics , Child , Child, Preschool , Humans , Infant , Molecular Diagnostic Techniques , Nucleic Acid Amplification Techniques , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/epidemiology , Seasons , Whooping Cough/diagnosis , Whooping Cough/epidemiologyABSTRACT
BACKGROUND: Pertussis is a disease leading to high morbidity and mortality in neonates and infants. Bronchiolitis is the most common cause of hospitalization especially in children < 2 year-old. Although the clinical findings are different in these two diseases, it is sometimes difficult to make this distinction in partially or fully vaccinated children. This study aimed to identify the incidence, clinical and laboratory effects of B. pertussis as a causative agent in hospitalized children with acute bronchiolitis. METHODS: The study included patients diagnosed with acute bronchiolitis and admitted to the Division of Pediatric Infectious Diseases from January 2012 to December 2015, aged 24 months or younger, evaluated for viruses and bacteria with polymerase chain reaction in respiratory tract secretions. RESULTS: The study included 380 patients hospitalized with acute bronchiolitis. Of these patients, 85.8% were identified to be positive for at least one respiratory pathogen. The most commonly identified pathogens were respiratory syncytial virus (RSV) A/B, rhinovirus, parainfluenza virus, adenovirus, bocavirus and metapneumovirus A/B. B. pertussis was only detected in 5 patients (1.5%). In the patients with B. pertussis identified, coinfection with another virus was observed including rhinovirus (n= 2), influenza A virus (n= 1), coronavirus OC43 (n= 1) and RSV A/B (n= 1). The presence of B. pertussis did not appear to cause any significant clinical or laboratory differences in patients. CONCLUSIONS: B. pertussis is a rare pathogen in patients admitted to hospital for acute bronchiolitis. However, in patients who do not respond to standard bronchiolitis treatment, B. pertussis should be considered as a causative agent. Early identification of this pathogen is important in terms of quarantining the patient, administering appropriate antimicrobial treatment, and prophylactic treatment to household and other close contacts.
Subject(s)
Bordetella pertussis , Bronchiolitis/virology , Hospitalization , Whooping Cough/epidemiology , Bronchiolitis/diagnosis , Bronchiolitis/therapy , Cohort Studies , Female , Humans , Incidence , Infant , Male , Whooping Cough/diagnosis , Whooping Cough/therapyABSTRACT
COVID-19 positive (194) and negative (212) pneumonia patients were selected to analyze bacterial pathogens coinfection. Results showed that 50% of COVID-19 patients were coinfected or carried bacterial pathogens. Bordetella pertussis infection rate was significantly higher in positive patients. Consequently, preventions should be taken to control bacterial pathogens coinfection in COVID-19 patients.