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Objective:To examine whether the mixed infection rate in pertussis infants is significantly higher than that in non-pertussis infants with respiratory tract infection, to explore the mixed infection pathogen distribution in pertussis infants, and to provide reference for clinical diagnosis and treatment.Methods:A case-control study was conducted on 118 nasopharyngeal swabs collected from infants who applied for clinical pertussis etiological testing (culture and specific nucleic acid detection of Bordetella pertussis) in Beijing Children′s Hospital, Jiaxing Maternity and Child Health Care Hospital and Wuhu No.1 People′s Hospital from August 2018 to January 2021.According to the pertussis etiological testing results, the patients were divided into the pertussis group (65 cases) and non-pertussis group (53 cases). Thirty-three pairs of cases were matched according to age, onset season and city.All nasopharyngeal swabs were tested for infections of other pathogens using FilmArray RP2, which can detect 21 respiratory infection pathogens.The mixed infection rate was compared between groups by Chi- square test. Results:According to the FilmArray RP2 test results, 56.9%(37/65) cases in pertussis group and 15.1%(8/53) cases in the non-pertussis group were positive for multiple pathogens, and the difference was statistically significant ( χ2=21.651, P<0.001). The top 5 mixed infection pathogens in pertussis infants were human rhinovirus/enterovirus (HRV/EV) (38.5%, 25/65), parainfluenza virus (PIV) (18.5%, 12/65), respiratory syncytial virus (RSV) (10.8%, 7/65), coronavirus (Cov) (10.8%, 7/65), and adenovirus (ADV) (7.7%, 5/65). The mixed infection rates of the pertussis group in spring, summer, autumn and winter were 46.2% (6/13), 58.3%(14/24), 55.6%(5/9), and 63.2%(12/19), respectively.Comparison of matched and unmatched cases achieved similar results. Conclusions:Among clinical suspected pertussis infant specimens, the mixed infection rate in confirmed cases is tremendously higher than that in non-pertussis infants.The main mixed infection pathogens in pertussis infants are HRV/EV, PIV, RSV, Cov, and ADV.Mixed infection in pertussis children commonly occurs in four seasons, with the highest incidence in winter.
ABSTRACT
There are a variety of factors contributing to pertussis resurgence, which is related to short duration of immunity provided by the vaccine, the difference of vaccination strategies, the change of epidemiological characteristics, antibiotic resistance, the variation of bordetella pertussis, the improvement of diagnostic criteria and the advancement of the monitoring system.There has been a decrease in the number of cases of natural infection since the vaccination, leading to a change in the prevalence of pertussis currently.The decline in population group immunity causes a decrease of serum antibody titer transmitted from the mother to the newborn.As a result, unvaccinated infants have poor immunity against pertussis in the early stage, and infants under 1 year old are prone to severe pertussis.Children and adolescents are also susceptible to pertussis owing to the short-term efficacy of the vaccine.They often present with chronic cough after infection.Adults infected with pertussis are unheeded because of atypical symptoms or occult infection, and they would infect young babies.To improve the diagnosis and treatment of pertussis, it is necessary to meliorate the laboratory diagnosis, study bacterial variation and drug resistance, strengthen disease surveillance, seek more optimized immunization strategies and develop new vaccines.In this paper, the causes of pertussis resurgence were reviewed, in order to provide reference for prevention and control of pertussis in China.
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Objective:To evaluate the auxiliary diagnosis value of bacterial culture, polymerase chain reaction (PCR) and serum anti-pertussis toxin immunoglobulin G (AntiPT-IgG) level detection in suspected pertussis.Methods:A total of 110 suspected cases of pertussis treated in the Department of Pediatrics of Wuhu No.1 People′s Hospital from June 2018 to May 2019 were recruited for the study.The nasopharyngeal swabs of all cases were collected for Bordetella pertussis culture and specific nucleic acid PCR detection.Serum samples of 78 cases were collected for the detection of AntiPT-IgG level by enzyme linked immunosorbent assays.Results:The positive rates of bacterial culture group and PCR group were 21.8% and 30.0%, respectively, with no statistically significant difference ( χ2=1.198, P>0.05). The culture positive rate of cases with the duration of cough<2 weeks was 32.1%, which was signi-ficantly higher than that of cases with the duration of cough about 2-4 weeks (14.3%) or >4 weeks (9.1%) ( χ2=6.522, P<0.05). The PCR positive rate of cases with the duration of cough <2 weeks was 39.6%, which was also significantly higher than that of cases with the duration of cough about 2-4 weeks (25.7%) or > 4 weeks (13.6%) ( χ2=6.126, P<0.05). The mean value for serum AntiPT-IgG level of 78 cases was (75.727±78.454) IU/mL, the median AntiPT-IgG levels of cases with the duration of cough<2 weeks and about 2-4 weeks were 5.909 IU/mL and 20.948 IU/mL, respectively, and the positive rates were 14.7% and 38.1%, respectively.The AntiPT-IgG level of cases with the duration of cough> 4 weeks and that at convalescent stage were (79.281±68.254) IU/mL and (107.242±75.750) IU/mL, and the positive rates were 39.1% and 57.1%, respectively. Conclusions:In the vaccine era, the results of pathogenic and serological tests should be combined to assist the clinical diagnosis of pertussis.The positive rate of bacterial culture and specific nucleic acid pathogen detection in children with cough duration less than 2 weeks is high, and the serological diagnosis is more effective after the duration of cough is over 4 weeks.
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Objective To investigate the effect of the cerebral protection and possible mechanism of fasudil for hypoxic-ischemic cerebral damage (HIBD) in neonatal rats. Methods The HBID model was established, then the mice were randomly divided into different groups. The expressions ofα-SMA and ROCK-2 were detected in the newborn rats with ischemia. Results Compared with the model group, expressions of α-SMA, ROCK-2 decreased in each treatment group with significant differences (P < 0.05 or P < 0.01). Following with the increases of administration dose and the administration time, expressions of α-SMA, ROCK-2 decreased gradually with significant differences (P<0.05 or P<0.01). Conclusion Fasudil can reduce the expressions of α-SMA, ROCK-2 in the newborn mice with hypoxic-ischemic brain damage to attenuate the brain tissue hypoxic-ischemic injury. The protective effect on brain is significant by giving high-dose fasudil in the early neonatal rat HIBD (0 h).
ABSTRACT
Benign infantile convulsions associated with mild gastroenteritis (BICE),known as convulsions with mild gastroenteritis,is a kind of non-febrile convulsions disease associated with acute infantile gastroenteritis.Patients with BICE often have mild gastroenteritis and tonic-clonic seizure manifestation,but no apparent disturbance of water,electrolyte and acid base was observed.BICE,the main etiological agent of which is Rotavirus,is a kind of self-limited disease with favorable prognosis,and no requiring of continuous anticonvulsant treatment.
