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Clinical impact of respiratory syncytial virus infection on children hospitalized for pertussis
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Clinical impact of respiratory syncytial virus infection on children hospitalized for pertussis
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Clinical impact of respiratory syncytial virus infection on children hospitalized for pertussis
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Journal Article
Clinical impact of respiratory syncytial virus infection on children hospitalized for pertussis
2021
Overview
Background
Although Respiratory syncytial virus (RSV) is one of the common pathogens in children with pertussis and viral coinfection, the clinical impact of RSV infection on pertussis remains unclear. We compared clinical characteristics and sought differences between infants with single
Bordetella pertussis
(
B. pertussis
) infection and those with RSV coinfection.
Methods
We enrolled 80 patients with pertussis who were hospitalized in Shenzhen Children’s Hospital from January 2017 to December 2019. Respiratory tract samples were tested for
B. pertussis
with real-time polymerase chain reaction and respiratory viruses with immunofluorescence assay. Clinical data were obtained from hospital records and collected using a structured questionnaire.
Results
Thirty-seven of 80 patients had
B. pertussis
infection alone (pertussis group) and 43 had RSV-pertussis coinfection (coinfection group). No significant differences were found with regard to sex, body weight, preterm birth history, pertussis vaccination, symptoms, presence of pneumonia, or lymphocyte count between the 2 groups. Univariate analysis showed patients with RSV coinfection were older (median, 4.57 months vs 4.03 months,
p
= 0.048); more commonly treated with β-lactam antibiotics (21% vs 5%,
p
= 0.044); had higher rates of wheezes (40% vs 14%,
p
= 0.009) and rales (35% vs 14%,
p
= 0.028) on chest auscultation, a higher rate of readmission (40% vs 11%,
p
= 0.004), and a longer hospital stay (median, 10 days vs 7 days,
p
= 0.002). In the further binary logistic regression analysis, patients with RSV coinfection had higher rates of wheezes (OR = 3.802; 95% CI: 1.106 to 13.072;
p
= 0.034) and readmission (OR = 5.835; 95% CI: 1.280 to 26.610;
p
= 0.023).
Conclusions
RSV coinfection increases readmission rate in children hospitalized for pertussis. RSV infection should be suspected when wheezes are present on auscultation of the chest in these patients. Early detection of RSV may avoid unnecessary antibiotic use.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
Subject
/ Anti-Bacterial Agents - therapeutic use
/ Bordetella pertussis - genetics
/ Bordetella pertussis - isolation & purification
/ Chest
/ Children
/ Communicable diseases in children
/ Female
/ Humans
/ Infant
/ Infants
/ Male
/ Medicine
/ Patients
/ Real-Time Polymerase Chain Reaction
/ Respiratory syncytial virus infection
/ Respiratory Syncytial Virus Infections - complications
/ Respiratory Syncytial Virus Infections - diagnosis
/ Respiratory Syncytial Virus Infections - virology
/ Respiratory Syncytial Virus, Human - genetics
/ Respiratory Syncytial Virus, Human - isolation & purification
/ Viruses
/ Whooping Cough - complications
/ Whooping Cough - drug therapy
