title: Clinical manifestations of children with microbiologically confirmed pertussis infection and antimicrobial susceptibility of isolated strains in a regional hospital in Japan, 2008-2012.
abstract: We conducted a retrospective study in 57 children (median age, 3.5 years; range, 1 month-14.5 years) with microbiologically confirmed pertussis infection over a recent 4-year period in a regional hospital in Japan. We obtained nasal swabs from all patients for Bordetella pertussis isolation as well as performed B. pertussis DNA detection using loop-mediated isothermal amplification (LAMP). Of the 57 cases, 34 (60%) were culture-positive and 57 (100%) were LAMP-positive. The frequency of each symptom was as follows: typical paroxysmal cough for over 14 days, 96% (55/57); paroxysms, 86% (49/57); posttussive vomiting, 33% (19/57); inspiratory whoop, 25% (14/57); and apnea, 12% (7/57). Hospitalization was required in 14 cases (25%), 93% (13/14) of which were aged <1 year. The proportion of patients previously immunized against diphtheria-tetanus-acellular pertussis vaccine (DTaP) was 19% (4/21) in children aged <1 year and 92% (11/12) in children aged ≥ 10 years. Minimum inhibitory concentrations for 6 antimicrobials (erythromycin, clarithromycin, azithromycin, minocycline, amoxicillin, and sulfamethoxazole/trimethoprim) were measured for 30 isolated strains, and all strains were susceptible to all aforementioned antimicrobials. Thus, an additional pertussis vaccination in older children is necessary, and the current macrolides-based treatment strategy is considered reasonable.
authors.affiliation: Department of Pediatrics, Konan Kosei Hospital.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Horiba
authors.forename: Naoko
authors.initials: N
authors.lastname: Nishimura
authors.forename: Kensei
authors.initials: K
authors.lastname: Gotoh
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kawaguchi
authors.forename: Suguru
authors.initials: S
authors.lastname: Takeuchi
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Hattori
authors.forename: Mai
authors.initials: M
authors.lastname: Isaji
authors.forename: Yu
authors.initials: Y
authors.lastname: Okai
authors.forename: Haruki
authors.initials: H
authors.lastname: Hosono
authors.forename: Koji
authors.initials: K
authors.lastname: Takemoto
authors.forename: Takao
authors.initials: T
authors.lastname: Ozaki
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001049:Apnea / Q000209:etiology / Q000473:pathology; D001886:Bordetella pertussis / Q000187:drug effects* / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000209:etiology / Q000473:pathology; D004269:DNA, Bacterial / Q000235:genetics / Q000302:isolation & purification; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006767:Hospitals, District; D006801:Humans; D007223:Infant; D007564:Japan; D008297:Male; D008826:Microbial Sensitivity Tests; D009297:Nasal Mucosa / Q000382:microbiology; D021141:Nucleic Acid Amplification Techniques; D012189:Retrospective Studies; D014839:Vomiting / Q000209:etiology / Q000473:pathology; D014917:Whooping Cough / Q000473:pathology*
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial