中国百日咳诊疗与预防指南(2024版)

Guidelines for diagnosis and management and prevention of pertussis of China (2024 edition)

百日咳再现是全球性的公共卫生问题,2018—2022年我国国内百日咳报告发病率接近20世纪80年代末的报告水平。实际上,我国的百日咳发病率被严重低估,主要因为国内尚未全面建立百日咳主动监测工作,不典型百日咳病例在临床上容易被漏诊,许多医疗机构未开展百日咳的实验室诊断;同时,我国还面临百日咳鲍特菌对一线抗菌药物大环内酯类高度耐药的临床问题。为了更好地指导和规范我国百日咳病例的临床诊疗、监测和防控工作,由感染病学、流行病学、免疫规划及指南方法学专家组成指南制订小组,从实践角度提出有关百日咳诊断、治疗、预防,尤其是疫苗免疫策略的12个临床问题,经过研究问题构建、证据检索和综合、证据评价以及证据到推荐意见讨论,制订推荐意见和实施建议,为从事百日咳诊疗和防控的临床医师、微生物实验室专业人员、医院感染控制专业人员以及公共卫生领域从事传染病防控和免疫规划的专业人员提供参考。

Pertussis re-emergence is a global public health concern.The reported incidence of pertussis in China from 2018 to 2022 was comparable to that in the late 1980s.In fact,the incidence of pertussis is still significantly underestimated in China,owing to a lack of comprehensive active pertussis surveillance,missed diagnosis of atypical pertussis cases,and the fact that many medical institutions do not perform pertussis laboratory diagnosis.Meanwhile,China is also faced with the clinical issue that Bordetella pertussis is highly resistant to first-line macrolide treatment.To better guide and standardize the clinical diagnosis,treatment,monitoring,prevention and control of pertussis cases in China,a multidisciplinary guideline development group comprised of experts in infectious diseases,epidemiology,immunization planning and guideline methodology proposed 12 clinical issues related to the diagnosis,treatment and prevention,especially vaccine immunization strategies from a practical perspective.Through research question construction,evidence retrieval and synthesis,evidence appraisal and evidence-to-decision discussion,recommendations and implementation suggestions were formulated to provide references for clinical physicians engaged in the diagnosis and management of pertussis,microbiological laboratory professionals,hospital infection control professionals,and public health professionals involved in infectious disease prevention,control and immunization planning.