Work

A retrospective study on pediatric pertussis: comprehensive evaluation of symptoms, laboratory indicators, and diagnostic efficacy of case definitions

Year: 2025

Type: article

Abstract: Objective This study aimed to characterize the epidemiology of pertussis in children, evaluate the diagnostic performance of clinical and laboratory features, assess the effectiveness of different suspected-case criteria, and identify independent risk factors for ICU admission. Methods We retrospectively analyzed demographic, clinical, and laboratory data from patients aged ≤14 years who underwent pertussis testing. Participants were stratified by test results, and the sensitivity and specificity of individual symptoms and laboratory parameters were calculated. Diagnostic performance was further assessed using univariate and multivariate logistic regression and nomogram analyses. Results Among 2,015 children tested, 724 (35.9%) were positive for pertussis, with 187 (30.2%) hospitalized and 55 (8.9%) admitted to the ICU. Cases increased from August 2023, peaking in May 2024, with the majority aged 3–11 years (51.8%). Compared with B. pertussis–negative children, positive cases exhibited higher WBC counts and procalcitonin (PCT) levels. Incorporating PCT into the WHO suspected-case definition improved the ROC area from 0.710 to 0.870, with an optimal cutoff of 0.1665 ng/mL. Cyanosis, post-tussive vomiting, neutrophil count, and assisted ventilation emerged as independent predictors of ICU admission, with a neutrophil cutoff of 6.62 × 10 9 /L. Conclusion The age distribution of pediatric pertussis shifted from young infants to preschool- and school-aged children. Clinical features alone are insufficient for reliable diagnosis due to overlap with non-pertussis cases. Elevated neutrophil count serves as an independent predictor of ICU admission, highlighting its potential utility for early risk stratification in pediatric pertussis.

Source: Frontiers in Cellular and Infection Microbiology

DOI: 10.3389/fcimb.2025.1694670