Pertussis clinical profile shift, severity, prediction in a tertiary hospital: A comparative study before, during, and after COVID-19 in Southern China
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 provid...
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| Language: | English |
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Elsevier
2025-01-01
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| Series: | Journal of Infection and Public Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1876034124003447 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Shufeng Tian |
| collection | DOAJ |
| description | 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 ratio, platelet count, cyanosis and pneumonia predicted disease severity. Conclusions: Post-pandemic, pertussis cases shifted from infants to school-aged children, with increased clinical severity and high macrolide resistance. Urgent measures are needed to optimize vaccination schedules and develop management strategies addressing and changing epidemiological patterns. |
| format | Article |
| id | doaj-art-91c1db4c68ca4591bb73cf22b5e6a9c7 |
| institution | DOAJ |
| issn | 1876-0341 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Infection and Public Health |
| spelling | doaj-art-91c1db4c68ca4591bb73cf22b5e6a9c72025-08-20T02:51:00ZengElsevierJournal of Infection and Public Health1876-03412025-01-0118110261010.1016/j.jiph.2024.102610Pertussis clinical profile shift, severity, prediction in a tertiary hospital: A comparative study before, during, and after COVID-19 in Southern ChinaShufeng Tian0Yulan Chen1Qiru Su2Biao Sun3Zengrui Lin4Yuchun Long5Hongmei Wang6Cuijuan Liao7Ying Zhang8Jinjun Zheng9Lvjun Chen10Song Guan11Sen Wang12Xinlei Xu13Jingwen Ai14Wenhong Zhang15Jikui Deng16Department of Infectious Diseases, Shenzhen Children’s Hospital, Shenzhen, ChinaDepartment of Infectious Diseases, Shenzhen Children’s Hospital, Shenzhen, ChinaDepartment of Infectious Diseases, Shenzhen Children’s Hospital, Shenzhen, ChinaDepartment of Infectious Diseases, Shenzhen Children’s Hospital, Shenzhen, ChinaDepartment of Infectious Diseases, Shenzhen Children’s Hospital, Shenzhen, ChinaDepartment of Infectious Diseases, Shenzhen Children’s Hospital, Shenzhen, ChinaDepartment of Infectious Diseases, Shenzhen Children’s Hospital, Shenzhen, ChinaDepartment of Infectious Diseases, Shenzhen Children’s Hospital, Shenzhen, ChinaDepartment of Infectious Diseases, Shenzhen Children’s Hospital, Shenzhen, ChinaDepartment of Infectious Diseases, Shenzhen Children’s Hospital, Shenzhen, ChinaDepartment of Infectious Diseases, Shenzhen Children’s Hospital, Shenzhen, ChinaDepartment of Infectious Diseases, Shenzhen Children’s Hospital, Shenzhen, ChinaDepartment of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Centre for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12, Urumqi Middle Road, Jing 'an District, Shanghai, China; Shanghai Sci-Tech Inno Centre for Infection and Immunity, Room 201, No. 6, Lane 1220, Huashan Road, Changning District, Shanghai, ChinaDepartment of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Centre for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12, Urumqi Middle Road, Jing 'an District, Shanghai, ChinaDepartment of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Centre for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12, Urumqi Middle Road, Jing 'an District, Shanghai, China; Shanghai Sci-Tech Inno Centre for Infection and Immunity, Room 201, No. 6, Lane 1220, Huashan Road, Changning District, Shanghai, China; Corresponding authors at: Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Centre for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12, Urumqi Middle Road, Jing 'an District, Shanghai, ChinaDepartment of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Centre for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12, Urumqi Middle Road, Jing 'an District, Shanghai, China; Shanghai Sci-Tech Inno Centre for Infection and Immunity, Room 201, No. 6, Lane 1220, Huashan Road, Changning District, Shanghai, China; Institute of Infection and Health, Fudan University, Shanghai, China; Corresponding authors at: Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Centre for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12, Urumqi Middle Road, Jing 'an District, Shanghai, ChinaDepartment of Infectious Diseases, Shenzhen Children’s Hospital, Shenzhen, China; Corresponding author.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 ratio, platelet count, cyanosis and pneumonia predicted disease severity. Conclusions: Post-pandemic, pertussis cases shifted from infants to school-aged children, with increased clinical severity and high macrolide resistance. Urgent measures are needed to optimize vaccination schedules and develop management strategies addressing and changing epidemiological patterns.http://www.sciencedirect.com/science/article/pii/S1876034124003447Bordetella pertussisMacrolide resistanceCOVID-19 pandemicRisk factorsEpidemiological and clinical changes |
| spellingShingle | 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 Pertussis clinical profile shift, severity, prediction in a tertiary hospital: A comparative study before, during, and after COVID-19 in Southern China Journal of Infection and Public Health Bordetella pertussis Macrolide resistance COVID-19 pandemic Risk factors Epidemiological and clinical changes |
| title | Pertussis clinical profile shift, severity, prediction in a tertiary hospital: A comparative study before, during, and after COVID-19 in Southern China |
| title_full | Pertussis clinical profile shift, severity, prediction in a tertiary hospital: A comparative study before, during, and after COVID-19 in Southern China |
| title_fullStr | Pertussis clinical profile shift, severity, prediction in a tertiary hospital: A comparative study before, during, and after COVID-19 in Southern China |
| title_full_unstemmed | Pertussis clinical profile shift, severity, prediction in a tertiary hospital: A comparative study before, during, and after COVID-19 in Southern China |
| title_short | Pertussis clinical profile shift, severity, prediction in a tertiary hospital: A comparative study before, during, and after COVID-19 in Southern China |
| title_sort | pertussis clinical profile shift severity prediction in a tertiary hospital a comparative study before during and after covid 19 in southern china |
| topic | Bordetella pertussis Macrolide resistance COVID-19 pandemic Risk factors Epidemiological and clinical changes |
| url | http://www.sciencedirect.com/science/article/pii/S1876034124003447 |
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