北京地区2011年至2016年迁延性咳嗽患儿中百日咳的检出率

The detection rate of pertussis in children and infants with persistent cough in Beijing during 2011-2016

目的了解迁延性咳嗽或慢性咳嗽患儿中百日咳感染的状况。方法以2011年至2016年首都儿科研究所中心实验室为检测中心,对北京市十余家医院符合入组条件的1318例患儿进行百日咳相关检查,采集疑诊百日咳患儿呼吸道分泌物及咽拭子标本及患儿咳嗽2周后血标本。多重PCR检测博德特百日咳杆菌,实时PCR检测百日咳杆菌核酸。结果1318例患儿中,男820例,女498例,百日咳检测阳性534例,其中百日咳杆菌阳性率为81.3%(434/534),百日咳杆菌-IgG抗体阳性率为31.8%(170/534),百日咳杆菌及百日咳杆菌-IgG抗体阳性率均为13.1%(70/534)。2011年至2016年检测例数从103例增加到460例,阳性例数从29例增加到194例。阳性患儿中年龄<1岁婴儿466例,占87.3%。第一季度百日咳患儿65例,第二季度151例,第三季度205例,第四季度113例。进一步分析268例首都儿科研究所附属儿童医院住院患儿,其中90.7%为散居儿童,未进行免疫患儿185例(69.0%),部分免疫71例(26.5%),完成全程免疫12例(4.5%)。百日咳住院患儿中,重症患儿占21.6%,死亡2例(0.8%),其余均好转出院。结论百日咳发病呈上升趋势,夏秋季发病为多,婴儿百日咳感染率高。百日咳杆菌是迁延性及慢性咳嗽患儿中的重要致病源。

ObjectiveTo investigate the prevalence of pertussis in infants and children with persistent cough in Beijing during 2011-2016.MethodsThe eligible infants and children from over ten hospitals who were suspected to have pertussis from 2011 to 2016 were enrolled for detection. Nasopharyngeal secretions and blood samples were collected. Multiplex-PCR was performed for Bordetella pertussis and real-time PCR was performed for nucleic acid of Bordetella pertussis.ResultsA total of 1 318 eligible cases were enrolled, including 820 males and 498 females. Pertussis was detected positive in 534 cases, including 81.3% (434/534) of B. pertussis positive cases and 31.8% (170/534) of IgG positive cases. There were 13.1% (70/534) had double positive for bacteria and antibodies. From 2011 to 2016, the enrolled patients were increased from 103 cases per year to 460 cases per year, and the test positive patients were increased from 29 cases to 194 cases. Among the pertussis patients, 466 (87.3%) cases were younger than one year old. From the first quarter to the fourth quarter of the year, There were 65 cases, 151 cases, 205 cases, and 113 cases, respectively. In further analysis of the 268 cases from Children′s Hospital affiliated to Capital Institute of Pediatrics, 90.7% of the patients who had whooping cough were scattered children; 185 cases (69.0%) of the patients had not begun programmed immunization, 71 cases (26.5%) did not complete programmed immunization and 12 cases (4.5%) completed the programmed immunization. Of all the inpatients, 21.6% were critical ill, 0.8% (2 cases) dead, and the remaining patients were recovered and discharged.ConclusionsThe prevalence of pertussis is increasing, especially in summer. Infants are the most susceptible population. Bordetella pertussis is one of the most important pathogen that can induce persistent and chronic cough.