Ruimu Zhang1, Jikui Deng2. 1. Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, China. 2. Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, China. szsetyydeng@sina.com.
Abstract
BACKGROUND: Although Respiratory syncytial virus (RSV) is one of the common pathogens in children with pertussis and viral coinfection, the clinical impact of RSV infection on pertussis remains unclear. We compared clinical characteristics and sought differences between infants with single Bordetella pertussis (B. pertussis) infection and those with RSV coinfection. METHODS: We enrolled 80 patients with pertussis who were hospitalized in Shenzhen Children's Hospital from January 2017 to December 2019. Respiratory tract samples were tested for B. pertussis with real-time polymerase chain reaction and respiratory viruses with immunofluorescence assay. Clinical data were obtained from hospital records and collected using a structured questionnaire. RESULTS: Thirty-seven of 80 patients had B. pertussis infection alone (pertussis group) and 43 had RSV-pertussis coinfection (coinfection group). No significant differences were found with regard to sex, body weight, preterm birth history, pertussis vaccination, symptoms, presence of pneumonia, or lymphocyte count between the 2 groups. Univariate analysis showed patients with RSV coinfection were older (median, 4.57 months vs 4.03 months, p = 0.048); more commonly treated with β-lactam antibiotics (21% vs 5%, p = 0.044); had higher rates of wheezes (40% vs 14%, p = 0.009) and rales (35% vs 14%, p = 0.028) on chest auscultation, a higher rate of readmission (40% vs 11%, p = 0.004), and a longer hospital stay (median, 10 days vs 7 days, p = 0.002). In the further binary logistic regression analysis, patients with RSV coinfection had higher rates of wheezes (OR = 3.802; 95% CI: 1.106 to 13.072; p = 0.034) and readmission (OR = 5.835; 95% CI: 1.280 to 26.610; p = 0.023). CONCLUSIONS: RSV coinfection increases readmission rate in children hospitalized for pertussis. RSV infection should be suspected when wheezes are present on auscultation of the chest in these patients. Early detection of RSV may avoid unnecessary antibiotic use.
BACKGROUND: Although Respiratory syncytial virus (RSV) is one of the common pathogens in children with pertussis and viral coinfection, the clinical impact of RSVinfection on pertussis remains unclear. We compared clinical characteristics and sought differences between infants with single Bordetella pertussis (B. pertussis) infection and those with RSVcoinfection. METHODS: We enrolled 80 patients with pertussis who were hospitalized in Shenzhen Children's Hospital from January 2017 to December 2019. Respiratory tract samples were tested for B. pertussis with real-time polymerase chain reaction and respiratory viruses with immunofluorescence assay. Clinical data were obtained from hospital records and collected using a structured questionnaire. RESULTS: Thirty-seven of 80 patients had B. pertussis infection alone (pertussis group) and 43 had RSV-pertussis coinfection (coinfection group). No significant differences were found with regard to sex, body weight, preterm birth history, pertussis vaccination, symptoms, presence of pneumonia, or lymphocyte count between the 2 groups. Univariate analysis showed patients with RSVcoinfection were older (median, 4.57 months vs 4.03 months, p = 0.048); more commonly treated with β-lactam antibiotics (21% vs 5%, p = 0.044); had higher rates of wheezes (40% vs 14%, p = 0.009) and rales (35% vs 14%, p = 0.028) on chest auscultation, a higher rate of readmission (40% vs 11%, p = 0.004), and a longer hospital stay (median, 10 days vs 7 days, p = 0.002). In the further binary logistic regression analysis, patients with RSVcoinfection had higher rates of wheezes (OR = 3.802; 95% CI: 1.106 to 13.072; p = 0.034) and readmission (OR = 5.835; 95% CI: 1.280 to 26.610; p = 0.023). CONCLUSIONS:RSVcoinfection increases readmission rate in children hospitalized for pertussis. RSVinfection should be suspected when wheezes are present on auscultation of the chest in these patients. Early detection of RSV may avoid unnecessary antibiotic use.
Authors: Chantal B van Houten; Christiana Naaktgeboren; Brigitte J M Buiteman; Maaike van der Lee; Adi Klein; Isaac Srugo; Irena Chistyakov; Wouter de Waal; Clemens B Meijssen; Pieter W Meijers; Karin M de Winter-de Groot; Tom F W Wolfs; Yael Shachor-Meyouhas; Michal Stein; Elisabeth A M Sanders; Louis J Bont Journal: Pediatr Infect Dis J Date: 2018-11 Impact factor: 2.129
Authors: M Pamela Griffin; Yuan Yuan; Therese Takas; Joseph B Domachowske; Shabir A Madhi; Paolo Manzoni; Eric A F Simões; Mark T Esser; Anis A Khan; Filip Dubovsky; Tonya Villafana; John P DeVincenzo Journal: N Engl J Med Date: 2020-07-30 Impact factor: 176.079
Authors: Ivana Pavic-Espinoza; Sandy Bendezú-Medina; Angella Herrera-Alzamora; Pablo Weilg; María J Pons; Miguel Angel Aguilar-Luis; Verónica Petrozzi-Helasvuo; Juana del Valle Mendoza Journal: BMC Infect Dis Date: 2015-12-02 Impact factor: 3.090
Authors: A Frassanito; R Nenna; A Nicolai; A Pierangeli; A E Tozzi; P Stefanelli; R Carsetti; C Concato; I Schiavoni; F Midulla Journal: BMC Infect Dis Date: 2017-07-12 Impact factor: 3.090
Authors: Elise Tessier; Helen Campbell; Sonia Ribeiro; Yuma Rai; Simon Burton; Partho Roy; Norman K Fry; David Litt; Gayatri Amirthalingam Journal: BMC Public Health Date: 2022-02-28 Impact factor: 3.295