The Study Of Clinical Prevalence And Characteristics Of Pertussis Among Hospitalized Children In Suzhou

Objective:To explore the clinical prevalence and characteristics of hospitalized Children with pertussis and the comparison of Clinical characteristics of Children with pertussis and suspected pertussis.Methods:We collected the respiratory secretions of all children admitted to the department of respiratory,affiliated Children's Hospital of Soochow University from February 2017 to July 2018,and the double target genes and multiple pathogens of pertussis bacillus were detected by Real-time PCR,including bacteria culture,direct immunofluorescence used to detect common seven respiratory viruses.At the same time,the peripheral venous blood was collected for blood routine examination,serum MP antibody and so on.To collect and arrange the clinical data of the selected children,compare the epidemiology and clinical characteristics of different ages,seasons and other pathogens infection,and use SPSS 19.0 statistical software to process the data.The counting data were expressed in percentage and chi-square test was used.For those with normal distribution,the mean ±standard deviation was used as the mean,and the single factor ANOVA was used in the comparison between groups.The median(quartile spacing)was used in the skewness distribution,and the rank sum test was used in the comparison between the two groups(P<0.05).There was a significant difference between the two groups(P<0.05).Results:Part I The clinical prevalence of pertussis among hospitalized children in Suzhou1.There were 1769 cases in the group,in which were 154 cares(8.71%)with PCR positive,of which 89 cases(57.8%)were males and 65 cases(42.2%)were females.2.The detectable rate of children ? 3 months old,~1 year old,~3 years old and>3 years old respectively was 9.74%?13.95%?5.35%and 3.17%.The detection rate of children aged from 3 months to 1 year was significantly higher than that of other age groups,and the difference was statistically significant(?2=42.226,P<0.001).3.The detection rates of spring,summer,autumn and winter were8.91%(55/617),13.64%(63/462),5.21%(17/326)and 5.22%(19/364),and the summer incidence was significantly higher than that of other seasons(?2=24.73,P<0.001),and there was significant difference between summer and autumn,summer and winter(?2=14.861,16.129,P<0.001).4.Among 154 positive children,96 cases(62.34%)were complicated with other pathogens,including 21 cases(13.64%)complicated with mycoplasma infection,64 cases(41.56%)mixed virus infection,3 8cases human respiratory rhinovirus.There were 7 cases of parainfluenza virus,16 cases of Boca virus,3 cases of syncytial virus,1 case of parainfluenza 1 virus and 2 cases of influenza virus A.There were 33 cases(21.42%)of mixed bacterial infections,including 14 cases of mixed Streptococcus pneumoniae,12 cases of mixed Haemophilus influenzae infection,3 cases of Casamora and 2 cases of Klebsiella pneumoniae.Part II Analysis of clinical characteristics of pertussis among hospitalized children in Suzhou1.In 154 cases of double PCR positive children,? 3 months old,? 1 year old,? 3 year old and>3 years old accounted for 24.7%(38/154)?53.9%(83/154)?13.0%(20/154)and 8.4%(13/154).respectively,the proportion of 3 months old to 1 year old was the highest(x2=42.226,P<0.001)2.The main manifestations of pertussis were paroxysmal spasm(76%),red complexion(64.9%),vomiting after cough(22.3%),paroxysmal cyanotic(16.2%)and rooster echo(10.4%).3.Among the positive for pertussis PCR,128 cases(83.1%)were not inoculated with pertussis vaccine,26cases(16.9%)were fully vaccinated with pertussis vaccine,and the spasmodic cough(81.2%,50%),complexion red(68.8%,46.2%)were higher than in the fully immunized group(?2=11.56?4.85 P=0.01?0.03).4.There was no significant difference between pertussis simple infection group and mixed infection group,such as rooster echo,paroxysmal cyanosis,postcough vomiting,severe pneumonia,absolute value of white blood cell and lymphocyte and length of stay in hospital.(P>0.05).5.In the pertussis group and the pertussis-like group,the roaring echo(22.7%)and complexion(85.3%)of the pertussis-like group were more than those in the pertussis group(10.4%and 64.9%)(x2=6.16?10.32,P=0.01?0.00),while the white blood cell(15.56×109/L)and lymphocyte counts(9.63×109/L)in the pertussis group were higher than those in the suspected pertussis group(11.97×109/L and 7.82×109/L)(Z?-2.71?-1.99,P=0.007?0.046).6.Of the 75 children with pertussis-like cough,there were 3 cases(4%)infection of mycoplasma pneumoniae,16 cases(21.3%)infections of rhinovirus infection,7 cases(9.3%)infection of parainfluenza virus,6 cases(8%)infection of Boca virus infection,3 cases(4%)infection of syncytial virus,8 cases(10.7%)infection of Haemophilus influenzae,and 6 cases(8%)of Streptococcus pneumoniae infection.Conclusions:1.Pertussis is common in Suzhou,and the detection rate of pertussis in children aged from 3 months to 1 year is the highest.2.Pertussis distributed throughout the year and peaked in summer.3.Children with pertussis are susceptible to infection with other pathogens.4.The infection rate of Bordetella pertussis in infants not vaccinated against pertussis was higher.5.Human rhinovirus,parainfluenza virus 3,Boca virus are the main pathogens of whooping cough.6.Pertussis and suspected pertussis cannot be distinguished from clinical manifestations alone,but the leukocyte and lymphocyte count in pertussis children is obviously higher than that in pertussis-like children,which can be used as the basis for clinical preliminary judgement.