학술논문

Clinical Characteristics of Hospitalized Infants With Laboratory-Confirmed Pertussis in Guatemala.
Document Type
Article
Source
Journal of the Pediatric Infectious Diseases Society. Dec2018, Vol. 7 Issue 4, p310-316. 7p.
Subject
*RESPIRATORY infections
*BORDETELLA pertussis
*CLINICAL pathology
*FEVER
*HOSPITAL care
*HOSPITAL admission & discharge
*INTENSIVE care units
*NASOPHARYNX
*PATIENTS
*PEDIATRICS
*POLYMERASE chain reaction
*PUBLIC health surveillance
*SYMPTOMS
*WHOOPING cough
*ACUTE diseases
*DISEASE duration
*LEUKOCYTE count
*LYMPHOCYTE count
*OROPHARYNX
*DIAGNOSIS
Language
ISSN
2048-7193
Abstract
Background Pertussis is an important cause of hospitalization and death in infants too young to be vaccinated (aged <2 months). Limited data on infant pertussis have been reported from Central America. The aim of this study was to characterize acute respiratory illnesses (ARIs) attributable to Bordetella pertussis among infants enrolled in an ongoing surveillance study in Guatemala. Methods As part of a population-based surveillance study in Guatemala, infants aged <2 months who presented with ARI and required hospitalization were enrolled, and nasopharyngeal and oropharyngeal swab specimens were obtained. For this study, these specimens were tested for B pertussis using real-time polymerase chain reaction (PCR). Results Among 301 infants hospitalized with ARI, we found 11 with pertussis confirmed by PCR (pertussis-positive infants). Compared to pertussis-negative infants, pertussis-positive infants had a higher mean admission white blood cell count (20900 vs 12579 cells/μl, respectively; P =.024), absolute lymphocyte count (11517 vs 5591 cells/μl, respectively; P <.001), rate of admission to the intensive care unit (64% vs 35%, respectively; P =.054), and case fatality rate (18% vs 3%, respectively; P =.014). Ten of the 11 pertussis-positive infants had cough at presentation; the majority (80%) of them had a cough duration of <7 days, and only 1 had a cough duration of >14 days. Fever (temperature ≥ 38°C) was documented in nearly half (45%) of the pertussis-positive infants (range, 38.0–38.4°C). Conclusions In this study of infants <2 months of age hospitalized with ARI in Guatemala, pertussis-positive infants had a high rate of intensive care unit admission and a higher case fatality rate than pertussis-negative infants. [ABSTRACT FROM AUTHOR]