A comparative study on the clinical manifestations of children infected with erythromycin-resistant Bordetella pertussis of ptxP1 and ptxP3 genotypes
10.3760/cma.j.cn101070-20231129-00388
- VernacularTitle:ptxP1与 ptxP3型红霉素耐药百日咳鲍特菌感染患儿临床表现的比较研究
- Author:
Mengyang GUO
1
;
Bingsong WANG
;
Lin YUAN
;
Zhen LI
;
Yahong HU
;
Qianqian DU
;
Wei SHI
;
Yajuan WANG
;
Kaihu YAO
Author Information
1. 国家儿童医学中心，首都医科大学附属北京儿童医院，北京市儿科研究所感染与微生物研究室，儿科学国家重点学科，儿科重大疾病研究教育部重点实验室，国家呼吸系统疾病临床医学研究中心，北京 100045
- Keywords:
Pertussis;
Clinical manifestation;
Erythromycin;
Resistance;
Genotype
- From:
Chinese Journal of Applied Clinical Pediatrics
2024;39(2):89-93
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To determine the erythromycin resistance of Bordetella pertussis isolates and their ptxP1 and ptxP3 phenotypic composition and compare clinical manifestations of children with pertussis caused by the two types of strains. Methods:This was a cross-sectional study, the pertussis cases diagnosed using bacterial culture from January 2019 to December 2022 in Beijing Children′s Hospital and the First People′s Hospital of Wuhu were collected.Any suspected Bordetella pertussis colonies were identified by the slide agglutination test.The susceptibility of isolates to erythromycin was detected by the E-test and K-B test.The ptxP gene was amplified by polymerase chain reaction and sequenced to determine its genotype. t-test, Mann-Whitney U-test, Chi-square test and Fisher′s exact test were use to statistical analysis. Results:A total of 192 strains of Bordetella pertussis were identified, including 188 (97.9%) erythromycin-resistant strains.Among the 188 strains, 30.3%(57/188) belonged to the ptxP1 genotype and 69.7%(131/188) belonged to the ptxP3 genotype.In children aged below 1 year old, the incidence of paroxysmal cough caused by infection with the ptxP3 strain was higher than that with the ptxP1 strain (57.1% vs.29.4%, P<0.05), and children infected with the ptxP3 strain were more likely to develop apnea or asphyxia (23.8% vs.17.6%), post-tussive vomiting (44.4% vs.32.4%), whooping cough (72.0% vs.50.0%) and pneumonia or bronchitis (85.7% vs.73.5%) compared to those infected with the ptxP1 strain, but the differences were not statistically significant(all P>0.05). In children aged 1 year old and above, the white blood cell count of children infected with the ptxP1 strain was higher than that of infections with the ptxP3 strain [13.5(9.9, 24.5)×10 9/L, 10.3 (7.0, 16.4)×10 9/L, P<0.05], and children infected with the ptxP1 strain were more likely to contract other pathogen infections than those infected with the ptxP3 strain (17.4% vs.4.4%, P>0.05). Conclusions:ptxP3 erythromycin-resistant Bordetella pertussis has become the main pathogen of pertussis.Infants with pertussis caused by the ptxP3 erythromycin-resistant strain show more significant manifestations and a higher possibility of severe symptoms than those infected with the ptxP1 erythromycin-resistant strain.
