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Study of mixed coinfections in children with pertussis

??Objective??To explore the clinical characteristics of coinfections in children with pertussis. Methods??From February 2016 to September 2017??198 cases with pertussis-like symptom were tested for PCR??bacterial culture??respiratory virus antigen and serum mycoplasma pneumoniae antibody in Children’s Hospital of Soochow University. Results??Totally 198 patients were enrolled and 105 patients were B.Pertussis positive. Single infection was in 37 cases??35.2%??. Coinfections were observed in 68??64.8%?? children with pertussis??including co-infection with one pathogen in 51 cases??75.0%??. The most frequent co-infection pathogen was rhinovirus??50.9%??26 cases????followed by Mycoplasma pneumoniae??13.7%??7 cases?? and Streptococcus pneumoniae??11.8%??6 cases??. There was no statistical difference in the coinfection rate among different age groups??P = 0.08??. Pertussis coinfection with MP was increased with age. Coinfections patients were older than those with single infections???11.77±2.32?? months vs. ??6.74±8.07?? months??P = 0.017??. Fever??dyspnea??and positive signs of lung in chest imang were more common in children with mixed infections??0 vs. 10.3%??20.6% vs. 5.4%??76.5% vs. 36.4%??P??0.05??. Chest imaging showed pathy shadow in most cases. There was no significant difference in lab tests??such as white blood cell counts??neutrophil counts??C-reactive protein??CRP????course of disease prior to admission or hospital stay between patients with pertussis only and those with mixed-pathogen infections??P??0.05??. Patients older than 3 months??OR??3.0??95%CI 1.1-8.5??P??0.03?? and fever??OR??2.5??95%CI 1.1-6.7??P??0.03?? were the independent risk factors for mixed infections. Conclusion??There is a higher proportion of coinfection in hospitalized children with pertussis??most commonly co-infected with rhinovirus??followed by Mycoplasma pneumoniae and Streptococcus pneumoniae. Coinfections are found to aggravate pertussis. Fever and being older than 3 months are risk factors of mixed infection.