Article in Japanese

Pertussis infections at a children's hospital

Kei MATSUDAIRA¹⁾, Mihoko FURUICHI²⁾, Yoshihiko MORIKAWA³⁾, Yuho HORIKOSHI²⁾

Diagnosing pertussis is challenging because of its low culture yield and time-consuming paired serology. The aim of this study was to investigate the clinical characteristics of pertussis in children diagnosed by conventional and molecular methods, loop-mediated isothermal amplification (LAMP) and polymerase chain reaction (PCR). Seventy-seven pediatric patients with pertussis were enrolled into the Tokyo Metropolitan Children's Medical Center from March 2010 to March 2015. The diagnosis was verified using cultures, pertussis toxin-IgG, LAMP, and PCR. The patients' median age was 10.3 months with 41/77 (53%) being infants. Cough was observed in 97%, and cyanosis seen in 39% of the patients. Of patients ≥ 3 months old, 36% had not received an adequate number of pertussis vaccine doses for their age. The rate of positive results for PCR, LAMP, pertussis toxin-IgG, and the cultures was 89%, 58%, 48% and 28%, respectively. In the 25 cases admitted to the pediatric intensive care unit (PICU), PICU admission was associated significantly with young age, low birth weight, presence of underlying diseases, delayed vaccination, and cyanosis. In conclusion, PCR and LAMP should be used to diagnose pertussis especially for children with risk of PICU admission and less than 3 months old.

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1) Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center
2) Department of Infectious Disease, Tokyo Metropolitan Children's Medical Center
3) Clinical Research Support Center, Tokyo Metropolitan Children's Medical Center

Key words	pertussis, infant, cough, cyanosis, gene amplification
Received	July 6, 2017
Accepted	December 22, 2017

29 (4)：336─344,2018