Pertussis clinical profile shift, severity, prediction in a tertiary hospital: A comparative study before, during, and after COVID-19 in Southern China

作者：Shufeng Tian, Yulan Chen, Qiru Su, Biao Sun, Zengrui Lin, Yuchun Long, Hongmei Wang, Cuijuan Liao, Ying Zhang, Jinjun Zheng, Lvjun Chen, Song Guan, Sen Wang, Xinlei Xu, Jingwen Ai, Wenhong Zhang, Jikui Deng · 发表于：Journal of Infection and Public Health · 年份：2024 · DOI：10.1016/j.jiph.2024.102610 · 被引用次数：15 · 研究领域：Bacterial Infections and Vaccines、Pneumonia and Respiratory Infections、Antibiotic Use and Resistance

OBJECTIVE: To analyze the epidemiological characteristics, clinical manifestations, antimicrobial resistance and develop a predictive model for severe pertussis spanning five years - before, during, and after the COVID-19 pandemic - in Shenzhen children's hospital in southern China, aiming to provide insights into the pandemic impact and control measures on the pertussis disease profile. METHODS: Demographic, clinical, vaccination, and laboratory data were collected for patients who tested positive for pertussis by polymerase chain reaction and/or culture from January 1, 2019, to March 30, 2024. Analysis included changes in demographic and clinical features, indicators of severe cases, and resistance patterns over the study period. RESULTS: During this period, 3963 patients were diagnosed, with 79 severe (PICU admitted) cases; 1433 isolates underwent antimicrobial susceptibility testing. In late 2023, pertussis cases began to increase. From 2019 to 2024, the proportion of cases among 4-6 year olds rose from 4.9 % to 28.6 %, and among 7-11 year olds from 0.7 % to 21.2 %. Macrolide resistance surged from 46.5 % in 2019 to 97.3 % in 2024, with 80 % of resistant hospitalized cases initially treated with macrolides. Clinical severity and co-infection increased post-pandemic, with a larger number of cases necessitating antibiotic changes and enhanced supportive care. Vaccination protected against severe disease. Indicators such as white blood cell count, lymphocyte to neutrophil ra...