The Re-Emergence of Pediatric Pertussis: Insights from a Regional Romanian Hospital

Introduction: Pertussis, a vaccine-preventable disease caused by Bordetella pertussis, is resurging globally due to declining immunization rates. This study explores the clinical and epidemiological features of pediatric pertussis cases in a regional Romanian hospital amid growing vaccine hesitancy....

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Main Authors: Ioana Rosca, Alina Turenschi, Alexandru Dinulescu, Victoria Lichii
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Antibiotics
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Online Access:https://www.mdpi.com/2079-6382/14/7/730
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author Ioana Rosca
Alina Turenschi
Alexandru Dinulescu
Victoria Lichii
author_facet Ioana Rosca
Alina Turenschi
Alexandru Dinulescu
Victoria Lichii
author_sort Ioana Rosca
collection DOAJ
description Introduction: Pertussis, a vaccine-preventable disease caused by Bordetella pertussis, is resurging globally due to declining immunization rates. This study explores the clinical and epidemiological features of pediatric pertussis cases in a regional Romanian hospital amid growing vaccine hesitancy. Methods: We conducted a retrospective cohort study on 99 children diagnosed with pertussis and admitted to Ploiești Pediatric Hospital between January 2024 and January 2025. Demographic, clinical, laboratory, and radiological data were analyzed using SPSS 25.0. Results: The median age was 11 months (IQR 4–25), with 12.1% under two months, and ineligible for the first DTaP dose. Notably, 72.7% of children were unvaccinated; 59.4% had missed scheduled doses. None of the mothers received the DTaP vaccination during pregnancy. Most cases (55.6%) had bilaterally accentuated interstitial patterns on chest X-ray, significantly associated with vaccination status (<i>p</i> = 0.019). The leukocyte count was higher in children with alveolar infiltrates (<i>p</i> = 0.028), and as the number of vaccine doses increased, the leukocyte count tended to slightly decrease (<i>p</i> = 0.022, R = −0.229). PCR confirmation was obtained after a mean of 2.2 days, with 12.1% of cases confirmed post-discharge. Azithromycin was used in 74.7% of cases, with good tolerability. Conclusions: Low pediatric and maternal vaccine uptake was a major contributor to pertussis resurgence in this cohort. Radiological severity correlated with vaccination status, suggesting that vaccination may confer protection not only against infection but also against severe pulmonary involvement. These findings support urgent public health efforts to restore vaccine confidence and coverage, particularly among vulnerable infant populations and expectant mothers.
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spelling doaj-art-fab6f59a66474f9c9268c7eabdb7efb52025-08-20T02:45:48ZengMDPI AGAntibiotics2079-63822025-07-0114773010.3390/antibiotics14070730The Re-Emergence of Pediatric Pertussis: Insights from a Regional Romanian HospitalIoana Rosca0Alina Turenschi1Alexandru Dinulescu2Victoria Lichii3Department of Neonatology, Faculty of Midwifery and Nursery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaPediatric Hospital Ploiesti, 100326 Ploiesti, RomaniaDepartment of Pediatrics, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaPediatric Hospital Ploiesti, 100326 Ploiesti, RomaniaIntroduction: Pertussis, a vaccine-preventable disease caused by Bordetella pertussis, is resurging globally due to declining immunization rates. This study explores the clinical and epidemiological features of pediatric pertussis cases in a regional Romanian hospital amid growing vaccine hesitancy. Methods: We conducted a retrospective cohort study on 99 children diagnosed with pertussis and admitted to Ploiești Pediatric Hospital between January 2024 and January 2025. Demographic, clinical, laboratory, and radiological data were analyzed using SPSS 25.0. Results: The median age was 11 months (IQR 4–25), with 12.1% under two months, and ineligible for the first DTaP dose. Notably, 72.7% of children were unvaccinated; 59.4% had missed scheduled doses. None of the mothers received the DTaP vaccination during pregnancy. Most cases (55.6%) had bilaterally accentuated interstitial patterns on chest X-ray, significantly associated with vaccination status (<i>p</i> = 0.019). The leukocyte count was higher in children with alveolar infiltrates (<i>p</i> = 0.028), and as the number of vaccine doses increased, the leukocyte count tended to slightly decrease (<i>p</i> = 0.022, R = −0.229). PCR confirmation was obtained after a mean of 2.2 days, with 12.1% of cases confirmed post-discharge. Azithromycin was used in 74.7% of cases, with good tolerability. Conclusions: Low pediatric and maternal vaccine uptake was a major contributor to pertussis resurgence in this cohort. Radiological severity correlated with vaccination status, suggesting that vaccination may confer protection not only against infection but also against severe pulmonary involvement. These findings support urgent public health efforts to restore vaccine confidence and coverage, particularly among vulnerable infant populations and expectant mothers.https://www.mdpi.com/2079-6382/14/7/730pertussisvaccine hesitancypediatric infectious diseasesmaternal immunizationRomaniawhooping cough
spellingShingle Ioana Rosca
Alina Turenschi
Alexandru Dinulescu
Victoria Lichii
The Re-Emergence of Pediatric Pertussis: Insights from a Regional Romanian Hospital
Antibiotics
pertussis
vaccine hesitancy
pediatric infectious diseases
maternal immunization
Romania
whooping cough
title The Re-Emergence of Pediatric Pertussis: Insights from a Regional Romanian Hospital
title_full The Re-Emergence of Pediatric Pertussis: Insights from a Regional Romanian Hospital
title_fullStr The Re-Emergence of Pediatric Pertussis: Insights from a Regional Romanian Hospital
title_full_unstemmed The Re-Emergence of Pediatric Pertussis: Insights from a Regional Romanian Hospital
title_short The Re-Emergence of Pediatric Pertussis: Insights from a Regional Romanian Hospital
title_sort re emergence of pediatric pertussis insights from a regional romanian hospital
topic pertussis
vaccine hesitancy
pediatric infectious diseases
maternal immunization
Romania
whooping cough
url https://www.mdpi.com/2079-6382/14/7/730
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