Clinical characteristics and molecular detection of Bordetella pertussis in hospitalized children with a clinical diagnosis of whooping cough in Peru
-
Juana del Valle-Mendoza
,
Cristina del Valle-Vargas
,
Ronald Aquino-Ortega
,
Luis J. del Valle
,
Erico Cieza-Mora
,
Wilmer Silva-Caso
,
Jorge Bazán-Mayra
,
Victor Zavaleta-Gavidia
,
Miguel Angel Aguilar-Luis
,
Hernán Cornejo-Pacherres
,
Johanna Martins-Luna
,
Angela Cornejo-Tapia
Abstract
Background and Objectives: Pertussis is an infectious disease caused by the Gram-negative bacterium Bordetella pertussis. In Peru, actual public health programs indicate that vaccination against B. pertussis must be mandatory and generalized, besides all detected cases must be reported. The objective of this study was to determine the prevalence of B. pertussis among children under five years of age with a presumptive diagnosis of whopping cough in Cajamarca, a region located in northern Peru.
Materials and Methods: The population of this cross-sectional study were children under 5 years old hospitalized as presumptive cases of pertussis during December 2017 to December 2018. The nasopharyngeal samples were analyzed by real-time PCR for the detection of B. pertussis.
Results: B. pertussis was identified as PCR + in 42.3% of our sample (33/78). The clinical presentation that was observed most frequently includes paroxysmal coughing (97%), difficulty breathing (69.7%), cyanosis (72.7%) and post-tussive emesis (60.6%). Additionally, pneumonia was the most observed complication (33.3%). Four of the patients with PCR+ for B. pertussis presented only lymphocytosis, five only leukocytosis, two patients with decreased leukocytosis and lymphocytes and only one patient with leukopenia and relative lymphocytosis. There was a percentage of 84.8% of unvaccinated children in the PCR+ group. Finally, the mother was the most frequent symptom carrier (18.2%).
Conclusion: In conclusion, in the studied population there is a high rate of PCR+ cases for B. pertussis. Laboratory values may show leukopenia or lymphopenia in patients with pertussis. It is necessary to use appropriate laboratory diagnostic tests in all infants with respiratory symptoms for B. pertussis. Since, the clinical diagnosis overestimates the diagnosis of pertussis.
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2. Yeung KHT, Duclos P, Nelson EAS, Hutubessy RCW. An update of the global burden of pertussis in children younger than 5 years: a modelling study. Lancet Infect Dis 2017;17:974-980.
3. Torres RS, Santos TZ, Torres RA, Pereira VV, Fávero LA, M Filho OR, et al. Resurgence of pertussis at the age of vaccination: clinical, epidemiological, and molecular aspects. J Pediatr (Rio J) 2015;91:333-338.
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6. Warfel JM, Beren J, Merkel TJ. Airborne transmission of Bordetella pertussis. J Infect Dis 2012 ;206:902-906.
7. Herfst S, Böhringer M, Karo B, Lawrence P, Lewis NS, Mina MJ, et al. Drivers of airborne human-to-human pathogen transmission. Curr Opin Virol 2017;22:22-29.
8. Falleiros Arlant LH, de Colsa A, Flores D, Brea J, Avila Aguero ML, Hozbor DF. Pertussis in Latin America: epidemiology and control strategies. Expert Rev Anti Infect Ther 2014;12:1265-1275.
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12. Berti E, Chiappini E, Orlandini E, Galli L, de Martino M. Pertussis is still common in a highly vaccinated infant population. Acta Paediatr 2014;103:846-849.
13. Chiappini E, Stival A, Galli L, de Martino M. Pertussis re-emergence in the post-vaccination era. BMC Infect Dis 2013;13:151.
14. Domínguez A, Godoy P, Toledo D, Soldevila N, García-Cenoz M, Farrús G, et al. Importance of enhanced surveillance for prevention of pertussis in children. Pediatr Infect Dis J 2015;34:729-733.
15. Cherry JD. Pertussis in young infants throughout the world. Clin Infect Dis 2016;63(suppl 4):S119-S122.
16. Centers for disease Control and Prevention (CDC) Pertussis (Whooping Cough) Surveillance & Reporting. 2019. Available at: https://www.cdc.gov/pertussis/surv-reporting.html
17. Torrent M, Badell I (2012). Intrepretación del hemograma y de las pruebas de coagulación. Madrid: Exlibris Ediciones, pp. 203-216.
18. Kösters K, Riffelmann M, VON König CHW. Evaluation of a real-time PCR assay for detection of Bordetella pertussis and B. parapertussis in clinical samples. J Med Microbiol 2001;50:436-440.
19. Aquino-Andrade A, Martínez-Leyva G, Mérida-Vieyra J, Saltigeral P, Lara A, Domínguez W, et al. Real-time polymerase chain reaction-based detection of Bordetella pertussis in Mexican infants and their contacts: A 3-year multicenter study. J Pediatr 2017;188:217-223.e1.
20. Bosch JJ, Fernández H, Polak FP, Musante G, Libster R, Rocca Rivarola M. Seroprevalence of Bordetella pertussis among vaccinated and unvaccinated pregnant women and newborn infants in a university hospital of Buenos Aires. Arch Argent Pediatr 2017;115:311-315.
21. Giayetto VO, Blanco S, Mangeaud A, Barbás MG, Cudolá A, Gallego SV. Caracterización de la infección por Bordetella pertussis Bordetella spp. y coqueluche en la provincia de Córdoba, Argentina [Features of Bordetella pertussis, Bordetella spp. infection and whopping cough in Córdoba province, Argentina]. Rev Chilena Infectol 2017;34:108-115.
22. Castillo ME, Bada C, Del Aguila O, Petrozzi-Helasvuo V, Casabona-Ore V, Reyes I, et al. Detection of Bordetella pertussis using a PCR test in infants younger than one year old hospitalized with whooping cough in five Peruvian hospitals. Int J Infect Dis 2015;41:36-41.
23. Del Valle-Mendoza J, Casabona-Oré V, Petrozzi-Helasvuo V, Cornejo-Tapia A, Weilg P, Pons MJ, et al. Bordetella pertussis diagnosis in children under five years of age in the Regional Hospital of Cajamarca, Northern Peru. J Infect Dev Ctries 2015;9:1180-1185.
24. Pavic-Espinoza I, Bendezú-Medina S, Herrera-Alzamora A, Weilg P, Pons MJ, Aguilar-Luis MA, et al. High prevalence of Bordetella pertussis in children under 5 years old hospitalized with acute respiratory infections in Lima, Peru. BMC Infect Dis 2015;15:554.
25. Del Valle-Mendoza J, Silva-Caso W, Aguilar-Luis MA, Del Valle-Vargas C, Cieza-Mora E, Martins-Luna J, et al. Bordetella pertussis in children hospitalized with a respiratory infection: clinical characteristics and pathogen detection in household contacts. BMC Res Notes 2018;11:318.
26. Tascini C, Carannante N, Sodano G, Tiberio C, Atripaldi L, Di Caprio G, et al. Neonatal pertussis diagnosis: low procalcitonin level and high lymphocyte count are able to discriminate pertussis from bacterial and viral infections. New Microbiol 2019;42:49-51.
27. Phadke VK, McCracken JP, Kriss JL, Lopez MR, Lindblade KA, Bryan JP, et al. Clinical characteristics of hospitalized infants with laboratory-confirmed pertussis in Guatemala. J Pediatric Infect Dis Soc 2018;7:310-316.
28. Fry NK, Duncan J, Wagner K, Tzivra O, Doshi N, Litt DJ, et al. Role of PCR in the diagnosis of pertussis infection in infants: 5 years' experience of provision of a same-day real-time PCR service in England and Wales from 2002 to 2007. J Med Microbiol 2009;58:1023-1029.
29. American Academy of Pediatrics. Pertussis (Whoop- ing Cough). Red Book: 2012 Report of the Committee on Infectious Diseases. American Academy of Pediat- rics, Elk Grove Village, IL; 2012.p. 553-66. Available at: https://reader.aappublications.org/red-book-29th-edition-2012/1
30. Villegas D, Echandía-Villegas CA, Echandía CA. Afebrile pneumonia (whooping cough) syndrome in infants at Hospital Universitario del Valle, Cali, 2001-2007. Colomb Med (Cali) 2012;43:114-118.
31. Huang HT, Gao ZG, Liu Y, Wang LJ, Liu YP, Zhang Y. Epidemiological characteristics and risk factors of the pertussis in infants < 12 months of age in Tianjin, China. Biomed Environ Sci 2017;30:545-548.
2. Yeung KHT, Duclos P, Nelson EAS, Hutubessy RCW. An update of the global burden of pertussis in children younger than 5 years: a modelling study. Lancet Infect Dis 2017;17:974-980.
3. Torres RS, Santos TZ, Torres RA, Pereira VV, Fávero LA, M Filho OR, et al. Resurgence of pertussis at the age of vaccination: clinical, epidemiological, and molecular aspects. J Pediatr (Rio J) 2015;91:333-338.
4. Bamberger ES, Srugo I. What is new in pertussis? Eur J Pediatr 2008;167:133-139.
5. Liese JG, Renner C, Stojanov S, Belohradsky BH, Munich Vaccine Study Group. Clinical and epidemiological picture of B. pertussis and B. parapertussis infections after introduction of acellular pertussis vaccines. Arch Dis Child 2003;88:684-687.
6. Warfel JM, Beren J, Merkel TJ. Airborne transmission of Bordetella pertussis. J Infect Dis 2012 ;206:902-906.
7. Herfst S, Böhringer M, Karo B, Lawrence P, Lewis NS, Mina MJ, et al. Drivers of airborne human-to-human pathogen transmission. Curr Opin Virol 2017;22:22-29.
8. Falleiros Arlant LH, de Colsa A, Flores D, Brea J, Avila Aguero ML, Hozbor DF. Pertussis in Latin America: epidemiology and control strategies. Expert Rev Anti Infect Ther 2014;12:1265-1275.
9. Dirección General de Epidemiología (DGE), Red Nacional de Epidemiologia (RENACE). Sala de Situación de Salud Perú: Tos Ferina. 2018. Available at: http://www.dge.gob.pe/portal/docs/vigilancia/sala/2018/SE52/tosf.pdf
10. Ministerio de Salud del Perú (MINSA). 2011. Esquema nacional de vacunación. Available at: http://bvs.minsa.gob.pe/local/MINSA/2060.pdf (accessed 21 March 2019).
11. Berti E, Venturini E, Galli L, de Martino M, Chiappini E. Management and prevention of pertussis infection in neonates. Expert Rev Anti Infect Ther 2014;12:1515-1531.
12. Berti E, Chiappini E, Orlandini E, Galli L, de Martino M. Pertussis is still common in a highly vaccinated infant population. Acta Paediatr 2014;103:846-849.
13. Chiappini E, Stival A, Galli L, de Martino M. Pertussis re-emergence in the post-vaccination era. BMC Infect Dis 2013;13:151.
14. Domínguez A, Godoy P, Toledo D, Soldevila N, García-Cenoz M, Farrús G, et al. Importance of enhanced surveillance for prevention of pertussis in children. Pediatr Infect Dis J 2015;34:729-733.
15. Cherry JD. Pertussis in young infants throughout the world. Clin Infect Dis 2016;63(suppl 4):S119-S122.
16. Centers for disease Control and Prevention (CDC) Pertussis (Whooping Cough) Surveillance & Reporting. 2019. Available at: https://www.cdc.gov/pertussis/surv-reporting.html
17. Torrent M, Badell I (2012). Intrepretación del hemograma y de las pruebas de coagulación. Madrid: Exlibris Ediciones, pp. 203-216.
18. Kösters K, Riffelmann M, VON König CHW. Evaluation of a real-time PCR assay for detection of Bordetella pertussis and B. parapertussis in clinical samples. J Med Microbiol 2001;50:436-440.
19. Aquino-Andrade A, Martínez-Leyva G, Mérida-Vieyra J, Saltigeral P, Lara A, Domínguez W, et al. Real-time polymerase chain reaction-based detection of Bordetella pertussis in Mexican infants and their contacts: A 3-year multicenter study. J Pediatr 2017;188:217-223.e1.
20. Bosch JJ, Fernández H, Polak FP, Musante G, Libster R, Rocca Rivarola M. Seroprevalence of Bordetella pertussis among vaccinated and unvaccinated pregnant women and newborn infants in a university hospital of Buenos Aires. Arch Argent Pediatr 2017;115:311-315.
21. Giayetto VO, Blanco S, Mangeaud A, Barbás MG, Cudolá A, Gallego SV. Caracterización de la infección por Bordetella pertussis Bordetella spp. y coqueluche en la provincia de Córdoba, Argentina [Features of Bordetella pertussis, Bordetella spp. infection and whopping cough in Córdoba province, Argentina]. Rev Chilena Infectol 2017;34:108-115.
22. Castillo ME, Bada C, Del Aguila O, Petrozzi-Helasvuo V, Casabona-Ore V, Reyes I, et al. Detection of Bordetella pertussis using a PCR test in infants younger than one year old hospitalized with whooping cough in five Peruvian hospitals. Int J Infect Dis 2015;41:36-41.
23. Del Valle-Mendoza J, Casabona-Oré V, Petrozzi-Helasvuo V, Cornejo-Tapia A, Weilg P, Pons MJ, et al. Bordetella pertussis diagnosis in children under five years of age in the Regional Hospital of Cajamarca, Northern Peru. J Infect Dev Ctries 2015;9:1180-1185.
24. Pavic-Espinoza I, Bendezú-Medina S, Herrera-Alzamora A, Weilg P, Pons MJ, Aguilar-Luis MA, et al. High prevalence of Bordetella pertussis in children under 5 years old hospitalized with acute respiratory infections in Lima, Peru. BMC Infect Dis 2015;15:554.
25. Del Valle-Mendoza J, Silva-Caso W, Aguilar-Luis MA, Del Valle-Vargas C, Cieza-Mora E, Martins-Luna J, et al. Bordetella pertussis in children hospitalized with a respiratory infection: clinical characteristics and pathogen detection in household contacts. BMC Res Notes 2018;11:318.
26. Tascini C, Carannante N, Sodano G, Tiberio C, Atripaldi L, Di Caprio G, et al. Neonatal pertussis diagnosis: low procalcitonin level and high lymphocyte count are able to discriminate pertussis from bacterial and viral infections. New Microbiol 2019;42:49-51.
27. Phadke VK, McCracken JP, Kriss JL, Lopez MR, Lindblade KA, Bryan JP, et al. Clinical characteristics of hospitalized infants with laboratory-confirmed pertussis in Guatemala. J Pediatric Infect Dis Soc 2018;7:310-316.
28. Fry NK, Duncan J, Wagner K, Tzivra O, Doshi N, Litt DJ, et al. Role of PCR in the diagnosis of pertussis infection in infants: 5 years' experience of provision of a same-day real-time PCR service in England and Wales from 2002 to 2007. J Med Microbiol 2009;58:1023-1029.
29. American Academy of Pediatrics. Pertussis (Whoop- ing Cough). Red Book: 2012 Report of the Committee on Infectious Diseases. American Academy of Pediat- rics, Elk Grove Village, IL; 2012.p. 553-66. Available at: https://reader.aappublications.org/red-book-29th-edition-2012/1
30. Villegas D, Echandía-Villegas CA, Echandía CA. Afebrile pneumonia (whooping cough) syndrome in infants at Hospital Universitario del Valle, Cali, 2001-2007. Colomb Med (Cali) 2012;43:114-118.
31. Huang HT, Gao ZG, Liu Y, Wang LJ, Liu YP, Zhang Y. Epidemiological characteristics and risk factors of the pertussis in infants < 12 months of age in Tianjin, China. Biomed Environ Sci 2017;30:545-548.
| Files | ||
| Issue | Vol 13 No 1 (2021) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijm.v13i1.5488 | |
| Keywords | ||
| Bordetella pertussis; Whooping cough; Real-time polymerase chain reaction; Peru | ||
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How to Cite
1.
del Valle-Mendoza J, del Valle-Vargas C, Aquino-Ortega R, del Valle L, Cieza-Mora E, Silva-Caso W, Bazán-Mayra J, Zavaleta-Gavidia V, Aguilar-Luis M A, Cornejo-Pacherres H, Martins-Luna J, Cornejo-Tapia A. Clinical characteristics and molecular detection of Bordetella pertussis in hospitalized children with a clinical diagnosis of whooping cough in Peru. Iran J Microbiol. 2021;13(1):23-30.
