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Belcher T, Coutte L, Debrie AS, Sencio V, Trottein F, Locht C, Cauchi S. Pertussis toxin-dependent and -independent protection by Bordetella pertussis against influenza. Microbes Infect 2024:105404. [PMID: 39128538 DOI: 10.1016/j.micinf.2024.105404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 08/06/2024] [Accepted: 08/06/2024] [Indexed: 08/13/2024]
Abstract
Bacterial-viral co-infections are frequent, but their reciprocal effects are not well understood. Here, we examined the effect Bordetella pertussis infection and the role of pertussis toxin (PT) on influenza A virus (IAV) infection and disease. In C57BL/6J mice, prior nasal administration of virulent B. pertussis BPSM and PT-deficient BPRA provided effective and sustained protection from IAV-induced mortality. However, BPSM or BPRA administered together with purified PT (BPRA + PT) had a stronger protective effect on weight loss compared to BPRA alone, reduced the viral load, and induced IL-17A in the lungs. In IL-17-/- mice, BPSM- and BPRA + PT-mediated protection against viral replication was abolished, while BPSM, BPRA and BPRA + PT provided similar levels of protection against IAV-induced mortality and weight loss. In conclusion, B. pertussis infection protects against influenza by two mechanisms: one reducing viral replication depending on PT and IL-17, and the other, independently of PT and IL-17, resulting in protection against influenza disease without reducing the viral load.
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Affiliation(s)
- Thomas Belcher
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL-Centre for Infection and Immunity of Lille, F-59000 Lille, France
| | - Loïc Coutte
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL-Centre for Infection and Immunity of Lille, F-59000 Lille, France
| | - Anne-Sophie Debrie
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL-Centre for Infection and Immunity of Lille, F-59000 Lille, France
| | - Valentin Sencio
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL-Centre for Infection and Immunity of Lille, F-59000 Lille, France
| | - François Trottein
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL-Centre for Infection and Immunity of Lille, F-59000 Lille, France
| | - Camille Locht
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL-Centre for Infection and Immunity of Lille, F-59000 Lille, France
| | - Stephane Cauchi
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL-Centre for Infection and Immunity of Lille, F-59000 Lille, France.
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Bennai RM, Zouaki A, El Amin G, Rahani A, Zirar J, Seffar M, Soully K, Mahraoui C, Kabbaj H. Pertussis outbreak in children hospitalized in Rabat (Morocco). Diagn Microbiol Infect Dis 2024; 109:116225. [PMID: 38492491 DOI: 10.1016/j.diagmicrobio.2024.116225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 02/11/2024] [Accepted: 02/19/2024] [Indexed: 03/18/2024]
Abstract
INTRODUCTION Cyclical pertussis epidemics primarily affect young infants. This study aims to estimate pertussis prevalence during the ongoing 2023 outbreak at our institution, focusing on affected age groups and clinical presentations. MATERIEL AND METHODS This retrospective study includes patients admitted to Rabat University Hospital Center from 1st January 2021 to 30th June 2023. Symptomatic patients underwent Multiplex Respiratory Panel PCR testing for respiratory infections. The analysis included cases where RT-PCR identified Bordetella spp., with data analysed using SPSS 15.0. RESULTS Pertussis cases sharply increased from December 2022, constituting 85.4 % of positive samples. Most cases (78.2 %) occurred in infants under 3 months, presenting symptoms such as coughing (94.5 %) and dyspnoea (94.5 %). Pertussis was suspected in 60 % of RT-PCR confirmed cases. B. pertussis DNA was identified in 81.8 % of cases and B. parapertussis DNA in 18.2 % of cases. CONCLUSION The study exposes a significant pertussis outbreak affecting predominantly young infants.
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Affiliation(s)
- Redouane Mammar Bennai
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco; Ibn Sina University Hospital Center, Specialties Hospital, Central Laboratory of Virology, Rabat, Morocco.
| | - Amal Zouaki
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco; Ibn Sina University Hospital Center, Specialties Hospital, Central Laboratory of Virology, Rabat, Morocco
| | - Ghizlane El Amin
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco; Ibn Sina University Hospital Center, Specialties Hospital, Central Laboratory of Virology, Rabat, Morocco
| | - Abdeljalil Rahani
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco; Ibn Sina University Hospital Center, Specialties Hospital, Central Laboratory of Virology, Rabat, Morocco
| | - Jalila Zirar
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco; Ibn Sina University Hospital Center, Specialties Hospital, Central Laboratory of Virology, Rabat, Morocco
| | - Myriam Seffar
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco; Ibn Sina University Hospital Center, Specialties Hospital, Central Laboratory of Virology, Rabat, Morocco
| | - Karim Soully
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco; Ibn Sina University Hospital Center, Central Laboratory of Bacteriology, Rabat, Morocco
| | - Chafik Mahraoui
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco; Ibn Sina University Hospital Center, Children Hospital, Rabat, Morocco
| | - Hakima Kabbaj
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco; Ibn Sina University Hospital Center, Specialties Hospital, Central Laboratory of Virology, Rabat, Morocco
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Li P, Fan X. Pertussis-like Syndrome Caused by Acinetobacter pittii ST119. Indian J Pediatr 2023; 90:1051. [PMID: 37351783 DOI: 10.1007/s12098-023-04728-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 06/06/2023] [Indexed: 06/24/2023]
Affiliation(s)
- Peng Li
- Department of Pediatrics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
| | - Xin Fan
- Department of Infectious Diseases & Clinical Microbiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
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Li C, Huang C, Zhang R, Wang H, Tian S, Tang YW, Deng J. Evaluation of BioFire Respiratory Panel 2 plus for Detection of Bordetella pertussis in Nasopharyngeal Swab Specimens from Children with Clinically Suspected Pertussis. Microbiol Spectr 2023; 11:e0180622. [PMID: 36602355 PMCID: PMC9927272 DOI: 10.1128/spectrum.01806-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
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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Affiliation(s)
- Chi Li
- Division of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, China
| | - Chaoying Huang
- Division of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, China
| | - Ruimu Zhang
- Division of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, China
| | - Hongmei Wang
- Division of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, China
- Department of Laboratory Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
- Department of Internal Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Shufeng Tian
- Division of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, China
| | - Yi-Wei Tang
- Department of Laboratory Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
- Department of Internal Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Jikui Deng
- Division of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, China
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Nakabembe E, Abu-Raya B, Kyohere M, Tusubira V, Amone A, Nakibuuka L, Cochet M, Nakimuli A, Voysey M, Gorringe A, Heath PT, Musoke P, Andrews N, Sekikubo M, Sadarangani M, Le Doare K. The safety and immunogenicity of a combined pertussis containing vaccine Tdap for HIV infected pregnant women and their newborns (WoMANPOWER) – A study protocol for a randomized clinical trial. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.17749.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Globally there are an estimated 24.1 million cases and 160,700 deaths from pertussis annually in children under five years. The disease burden is higher in low- and middle-income countries, especially the African region, which contributes the largest proportions of cases and deaths. Immunization against pertussis in pregnancy is a recommended strategy for the prevention of infant pertussis in many high-income countries. However, vaccine immunogenicity and effectiveness may be different in immunocompromised individuals such as women living with HIV. There is a need to generate data on the impact of HIV infection in pregnancy on maternal and infant immunity to vaccines against pertussis. Methods: This is a phase II, randomized controlled observer blind clinical trial of 100 women living with HIV and 100 uninfected women randomized to either standard vaccines (tetanus diphtheria vaccine, Td) or a tetanus diphtheria-pertussis vaccine (Tdap). Participants aged 18-40 years carrying a low-risk singleton pregnancy with a gestational age between 16 and 26 weeks confirmed on ultrasound scan, with no history of receipt of tetanus or pertussis vaccines in the current pregnancy will be recruited. Women will receive either two doses of Td or a first dose of Td and second dose of Tdap vaccine. Participants will complete 14-day diary cards to monitor reactogenicity. Mother-infant dyads will be followed up until the infant is one year old. The outcomes include: safety for the pregnant woman and infant; anti-pertussis toxin (PT) and anti-filamentous haemagglutinin (FHA) IgG concentrations in maternal, cord and infant blood and breastmilk, compared by maternal HIV status. Discussion: This study will investigate whether vaccines given to women living with HIV have similar immunogenicity and reactogenicity to vaccines given to pregnant women without HIV and monitor the effect of Tdap in pregnancy on infant immune responses. clinicalTrials.gov registration: NCT04589312 (19/10/2020)
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Zhao X, Meng Y, Li D, Feng Z, Huang W, Li X, Wei H, Zeng X, Wang D. Retrospective study of clinical characteristics and viral etiologies of patients with viral pneumonia in Beijing. Pulm Circ 2021; 11:20458940211011027. [PMID: 34221349 PMCID: PMC8221751 DOI: 10.1177/20458940211011027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/30/2021] [Indexed: 12/31/2022] Open
Abstract
Aims The virus is common in patients with viral pneumonia. However, the viral etiology and clinical features of patients with viral pneumonia in China remain unclear. The main purpose of this study was to analyze the viral causes and epidemiology of patients with viral pneumonia in Beijing, which can significantly improve the pertinence and accuracy of clinical treatment of the disease. Methods Firstly, 1539 respiratory specimens of pneumonia (oropharyngeal swabs, nasopharyngeal swabs, saliva samples and bronchoalveolar lavage fluid) were collected from 19 hospitals in Beijing from September 2015 to August 2018. Then, TaqMan low-density microfluidic chip technology was used to detect viral pneumonia specimens in 1539 respiratory tract specimens of pneumonia and determine the types of viral bacteria in them. Lastly, the analysis of demographic, clinical and etiological data of patients with viral pneumonia was performed. Results The results showed that among the 1539 respiratory tract specimens with pneumonia, 760 were detected as viral pneumonia specimens, with a positive rate of 49.4%. Among which, 467 were infected with mono-viral and 293 were infected with multi-viral. Influenza A virus (Flu A), mycoplasma pneumoniae (MPn), Ebola virus (EBV) and herpes simplex virus type 1 (HSV-1) were the major viral components in the samples of these patients. Furthermore, these viral species were significantly associated with sample sources, onset season and certain clinical characteristics. Discussion Our findings may provide corresponding treatment strategies for viral pneumonia patients infected with specific viruses.
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Affiliation(s)
- Xiang Zhao
- Department of Influenza, WHO Collaborating Centre for Reference and Research on Influenza, Chinese National Influenza Centre, National Institute for Viral Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, PR China
| | - Yao Meng
- Department of Influenza, Shaanxi Provincial Center for Disease Control and Prevention, Xian City, PR China
| | - Duo Li
- Department of Influenza, Yunnan Provincial Center for Disease Control and Prevention, Kunming City, PR China
| | - Zhaomin Feng
- Department of Influenza, WHO Collaborating Centre for Reference and Research on Influenza, Chinese National Influenza Centre, National Institute for Viral Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, PR China
| | - Weijuan Huang
- Department of Influenza, WHO Collaborating Centre for Reference and Research on Influenza, Chinese National Influenza Centre, National Institute for Viral Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, PR China
| | - Xiyan Li
- Department of Influenza, WHO Collaborating Centre for Reference and Research on Influenza, Chinese National Influenza Centre, National Institute for Viral Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, PR China
| | - Hejiang Wei
- Department of Influenza, WHO Collaborating Centre for Reference and Research on Influenza, Chinese National Influenza Centre, National Institute for Viral Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, PR China
| | - Xiaoxu Zeng
- Department of Influenza, WHO Collaborating Centre for Reference and Research on Influenza, Chinese National Influenza Centre, National Institute for Viral Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, PR China
| | - Dayan Wang
- Department of Influenza, WHO Collaborating Centre for Reference and Research on Influenza, Chinese National Influenza Centre, National Institute for Viral Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, PR China
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Liu Y, Ai T, Fan Y, Xie C, Lou R, Zeng X, Wang L, Peng Y, Chen M. Etiological distribution of pertussis-like syndrome in 756 children in Chengdu. Transl Pediatr 2021; 10:984-989. [PMID: 34012846 PMCID: PMC8107860 DOI: 10.21037/tp-21-140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND To analyze and summarize the etiological distribution of pertussis-like syndrome in children and to provide a basis for clinical treatment. METHODS A retrospective analysis was conducted of 756 children with pertussis-like syndrome hospitalized at the Department of Pediatric Respiratory Medicine of Chengdu Women's and Children's Central Hospital, 2015 to 2019. The etiological features were classified and reviewed. RESULTS Among 756 children with pertussis-like syndrome, 439 cases were positive for etiological agents Among the 439 cases, 268 cases were positive for bacterial agents (positive rate 35.45%), including 174 cases (65.25%) positive for Haemophilus influenza (H. influenza). There were 75 cases (9.92%) positive for viral antibodies, including 29 cases (accounting for 38.67% of all cases positive for viral infection) positive for the respiratory syncytial virus (RSV). There were 243 cases (32.14%) positive for Mycoplasma pneumoniae (M. pneumoniae) antibodies. As to the general distribution of infections, cases with infections caused by a single type of bacteria accounted for 20.63%; cases with M. pneumoniae infection accounted for 18.78%; and cases with bacterial infection combined with M. pneumoniae infection accounted for 8.73%. CONCLUSIONS H. influenza, RSV, and M. pneumoniae were important pathogens causing pertussis-like syndrome in children. Bacterial infection, M. pneumoniae infection, and mixed infection caused by the two pathogens were the primary causes of pertussis-like syndrome in children.
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Affiliation(s)
- Yanru Liu
- Department of Pediatric Respiratory Medicine, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Tao Ai
- Department of Pediatric Respiratory Medicine, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yinghong Fan
- Department of Pediatric Respiratory Medicine, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Cheng Xie
- Department of Pediatric Respiratory Medicine, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Ronghua Lou
- Department of Pediatric Respiratory Medicine, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiangdong Zeng
- Department of Pediatric Respiratory Medicine, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Li Wang
- Department of Pediatric Respiratory Medicine, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yi Peng
- Department of Pediatric Respiratory Medicine, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Mingjia Chen
- Department of Pediatric Respiratory Medicine, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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Liu D, Du Q, Yuan L, Wang Q, Shi W, Meng Q, Yu D, Yao K. Retrospective analysis of bacterial culture-confirmed pertussis cases in Beijing Children's hospital from 2014 to 2019 reveals prevention and control of the grim situation in mainland China. Expert Rev Vaccines 2021; 20:577-583. [PMID: 33691571 DOI: 10.1080/14760584.2021.1899822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Our study aims to explore the epidemiological features of children with bacterial culture-confirmed pertussis visiting Beijing Children's Hospital, China. METHODS From 2014 through 2019, patients with suspected pertussis coming from mainland China provided nasopharyngeal swabs and bacterial culture that was subsequently cultivated. RESULTS During the study period, 6956 children with suspected pertussis from 30 different administrative provinces of mainland China were investigated, of which 1494 cases (21.5%) had positive B. pertussis culture. The number of pertussis cases increased year-on-year, from 122 in 2014 to 279 in 2019. Of the confirmed cases, 38.2% and 26.8% were identified in the summer and autumn, respectively. The age distribution of children with pertussis showed that 77.2% were <12 months old, including 56.0% <6 months old. Only thirteen B. parapertussis isolates and one B. bronchiseptica isolates were collected in the present samples. CONCLUSIONS The present culture-confirmed cases reveal the severe epidemic situation of pertussis spreading over the whole country and mainly affecting the infants. It is necessary to set up hospital-based surveillance with reliable laboratory methods to promote clinical awareness and to monitor the disease.
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Affiliation(s)
- Dandan Liu
- MOE Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University) National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Qianqian Du
- MOE Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University) National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Lin Yuan
- MOE Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University) National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Qing Wang
- MOE Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University) National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Wei Shi
- MOE Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University) National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Qinghong Meng
- MOE Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University) National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Dan Yu
- MOE Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University) National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Kaihu Yao
- MOE Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University) National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
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9
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Arango-Granados MC, Trompa IM. Neurologic alterations in an HIV adult patient with pertussis: a case report. BMC Infect Dis 2020; 20:471. [PMID: 32615931 PMCID: PMC7330534 DOI: 10.1186/s12879-020-05198-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 06/24/2020] [Indexed: 11/26/2022] Open
Abstract
Background Pertussis is a highly contagious disease of public health interest caused by the bacterium Bordetella pertussis. Although its incidence has decreased substantially after the introduction of a vaccination, the burden of the disease remains high. Although the paroxysmal phase is highly disabling, complications are uncommon and more prevalent in children than in adults. The most frequent neurological complication is encephalopathy, but seizures, paresis, paraplegia, ataxias, aphasias, and decerebration postures have also been described. The complication of decerebration postures has not been previously reported in adults. Case presentation We present a video case of an adult HIV patient with severe coughing paroxysms, post-tussive emesis and syncope, whose workup confirmed the diagnosis of a B. pertussis respiratory infection. During hospitalization, he had fluctuant encephalopathy and post-tussive decerebration postures following paroxysms. He was treated with antibiotic therapy and finally sent home without residual neurological deficits. Conclusion This case illustrates the biological plausibility of neurologic complications of pertussis in adults, which, albeit rare, can cause important morbidities. Future research should explore whether there are differences in the clinical presentation, risk factors and pathophysiology of the disease among adults or interventions aimed at preventing or treating pertussis encephalopathy.
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Affiliation(s)
- María Camila Arango-Granados
- Emergency Department, Fundación Valle del Lili, Cra 98 # 18 - 49, Cali, Valle del Cauca, Colombia. .,School of Medicine, Universidad Icesi, Cl. 18 # 122 - 135, Cali, Valle del Cauca, Colombia.
| | - Iván Mauricio Trompa
- IPS Universitaria León XIII, Infectology Service, Cl. 69 # 51C - 24, Medellín, Antioquia, Colombia.,School of Medicine, Universidad de Antioquia, Cl. 67 # 53 -108, Medellín, Antioquia, Colombia
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10
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Xiong Q, Hao S, Shen L, Liu J, Chen T, Zhang G, Huang YJ. Pertussis-like syndrome often not associated with Bordetella pertussis: 5-year study in a large children's hospital. Infect Dis (Lond) 2020; 52:736-742. [PMID: 32589094 DOI: 10.1080/23744235.2020.1784995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Background: Recently, a resurgence of pertussis has been observed worldwide despite broad vaccination coverage. The purpose of this study was to identify the clinical characteristics and the aetiological agent of pertussis-like syndrome (PLS) in Eastern China.Methods: 1168 patients who were diagnosed with a suspected Bordetella pertussis in Shanghai Children's Hospital from 2013 to 2017 were included in the study. Clinical features and aetiologies were analysed. Aetiological analyses in sub-cohorts of age, seasons and years were also investigated.Results: 96.0% (1121) of the patients were less than 12 months old. 59.0% (689) of the patients were male. The Top 5 pathogens were respiratory syncytial virus (RSV; n = 125; 10.7%), Streptococcus pneumonia (SP; n = 109; 9.3%), Haemophilus influenzae type b (HIB; n = 86; 7.4%), Bordetella pertussis (B. pertussis; n = 84; 7.2%), and Mycoplasma pneumonia (MP; n = 80; 6.9%), respectively. The percentage of SP in the age group of 0-3 months was significantly lower than that in other age groups. The percentage of B. pertussis in the age group of 3-6 months was significantly lower than that in the group of 6-12 months. The percentage of MP in 0-3 months' group was significantly lower than that in >12 months group. RSV peaked in winter (n = 52), while HIB peaked in spring (n = 38).Conclusion: PLS occurred most often in infants. RSV, SP, HIB, B. pertussis, and MP were the most prevalent pathogens. Since patients with B. pertussis and other pathogens have similar clinical manifestations, diagnosis of pertussis should be based on both clinical symptoms and laboratory confirmation.
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Affiliation(s)
- Qin Xiong
- Department of Emergency, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shiying Hao
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, CA, USA.,Clinical and Translational Research Program, Betty Irene Moore Children's Heart Center, Lucile Packard Children's Hospital, Palo Alto, CA, USA
| | - Lei Shen
- Department of Emergency, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian Liu
- Department of Emergency, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tingting Chen
- Department of Emergency, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guoqin Zhang
- Department of Emergency, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu-Juan Huang
- Department of Emergency, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Cao J, Xu L, Pan J. Analysis of Multiple Factors Involved in Pertussis-Like Coughing. Clin Pediatr (Phila) 2020; 59:641-646. [PMID: 32075427 DOI: 10.1177/0009922820905871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives. To identify risk factors associated with the prognosis of pertussis-like coughing. Methods. A retrospective study on children hospitalized with pertussis-like coughing from 2018 to 2019. We collected all the case data from medical records including age, gender, vaccination, clinical symptoms, complication, pathogens, white blood cell (WBC) count, lymphocyte ratio, application of macrolide antibiotics, usage of sulfamethoxazole, and usage of inhaled glucocorticoids. Logistic regression was used in this study. Results. A total of 213 hospitalized children with pertussis-like coughing were included in this study. About 70 children were cured within 2 weeks. One120 children were cured from 2 weeks to 3 months, including cases of initial attack and relapse. Symptoms lasting longer than 3 months accounts for 10.8%. Bordetella pertussis, WBC count >20 × 109/L and lymphocyte ratio >60% were associated with poor prognosis (P < .05). Conclusions. Bordetella pertussis, WBC count, and lymphocyte ratio are independent risk factors for poor prognosis.
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Affiliation(s)
- Jiaying Cao
- Anhui Medical University, Hefei, China.,Anhui Provincial Hospital, Hefei, China
| | - Lu Xu
- Anhui Medical University, Hefei, China
| | - Jiahua Pan
- Anhui Medical University, Hefei, China.,Anhui Provincial Hospital, Hefei, China
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Gu W, Wang K, Zhang X, Hao C, Lu Y, Wu M, Chen S, He Y, Xu J, Shao X, Wang Y. Pathogen analysis of pertussis-like syndrome in children. BMC Infect Dis 2020; 20:353. [PMID: 32429853 PMCID: PMC7236299 DOI: 10.1186/s12879-020-05074-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 05/05/2020] [Indexed: 12/24/2022] Open
Abstract
Background The aim of the study was to identify the pathogens, in addition to bordetella pertussis (B. pertussis), which cause pertussis-like syndrome in children and to compare clinical presentation between those with B. pertussis and pertussis-like syndrome. Methods A cross-sectional analysis was conducted from March 2016 to September 2018. In total, 281 children with suspected pertussis infections were enrolled in this study. Multi-pathogen detection was performed. Results In total, 281 children were enrolled including 139 males and 142 females. Among them, 149 (53.0%) were B. pertussis positive, and 72 (15.6%) children tested positive for other pathogens. Mycoplasma pneumoniae (MP, 27 cases) was the most common causative pathogen in pertussis-like syndrome, followed by human rhinovirus (HRV, 23 cases), Streptococcus pneumoniae (SP, 13 cases), Haemophilus influenzae (HI, 12 cases) and parainfluenza virus 3 (Pinf-3, 9 cases). Children in the B. pertussis group had a higher rate of vaccination and longer hospital stay (P < 0.05). B. pertussis was more likely to be detected in winter than other pathogens, but this difference was not significant (P = 0.074). The number of white blood cells, neutrophils and blood platelets was significantly higher in children in the B. pertussis than in the pertussis-like group (P < 0.05). In addition, the percentage of CD3-CD19+ cells was significantly higher in the B. pertussis group (P = 0.018). Conclusion About half of the children with pertussis-like syndrome were B. pertussis positive. MP was the second most common causative pathogen followed by HRV, SP, HI and Pinf-3. Children infected with B. pertussis had longer hospital stay and higher numbers of white blood cells, neutrophil and blood platelets compared with other pathogens.
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Affiliation(s)
- Wenjing Gu
- Department of Respiration, Children's Hospital of Soochow University, No. 303 Jing De Road, Suzhou, 215003, China
| | - Kun Wang
- Department of Respiration, Children's Hospital of Soochow University, No. 303 Jing De Road, Suzhou, 215003, China
| | - Xinxing Zhang
- Department of Respiration, Children's Hospital of Soochow University, No. 303 Jing De Road, Suzhou, 215003, China
| | - Chuangli Hao
- Department of Respiration, Children's Hospital of Soochow University, No. 303 Jing De Road, Suzhou, 215003, China
| | - Yanhong Lu
- Department of Respiration, Children's Hospital of Soochow University, No. 303 Jing De Road, Suzhou, 215003, China
| | - Min Wu
- Department of Respiration, Children's Hospital of Soochow University, No. 303 Jing De Road, Suzhou, 215003, China
| | - Sainan Chen
- Department of Respiration, Children's Hospital of Soochow University, No. 303 Jing De Road, Suzhou, 215003, China
| | - Yanyu He
- Department of Respiration, Children's Hospital of Soochow University, No. 303 Jing De Road, Suzhou, 215003, China
| | - Jun Xu
- Department of Clinical laboratory, Children's Hospital of Soochow University, Suzhou, 215003, China
| | - Xuejun Shao
- Department of Clinical laboratory, Children's Hospital of Soochow University, Suzhou, 215003, China
| | - Yuqing Wang
- Department of Respiration, Children's Hospital of Soochow University, No. 303 Jing De Road, Suzhou, 215003, China.
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Gestal MC, Johnson HM, Harvill ET. Immunomodulation as a Novel Strategy for Prevention and Treatment of Bordetella spp. Infections. Front Immunol 2019; 10:2869. [PMID: 31921136 PMCID: PMC6923730 DOI: 10.3389/fimmu.2019.02869] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/22/2019] [Indexed: 12/13/2022] Open
Abstract
Well-adapted pathogens have evolved to survive the many challenges of a robust immune response. Defending against all host antimicrobials simultaneously would be exceedingly difficult, if not impossible, so many co-evolved organisms utilize immunomodulatory tools to subvert, distract, and/or evade the host immune response. Bordetella spp. present many examples of the diversity of immunomodulators and an exceptional experimental system in which to study them. Recent advances in this experimental system suggest strategies for interventions that tweak immunity to disrupt bacterial immunomodulation, engaging more effective host immunity to better prevent and treat infections. Here we review advances in the understanding of respiratory pathogens, with special focus on Bordetella spp., and prospects for the use of immune-stimulatory interventions in the prevention and treatment of infection.
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Affiliation(s)
- Monica C Gestal
- Department of Infectious Diseases, College of Veterinary Sciences, University of Georgia, Athens, GA, United States
| | - Hannah M Johnson
- Department of Infectious Diseases, College of Veterinary Sciences, University of Georgia, Athens, GA, United States
| | - Eric T Harvill
- Department of Infectious Diseases, College of Veterinary Sciences, University of Georgia, Athens, GA, United States
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