1
|
Noel G, Lotfi MN, Mirshahvalad S, Mahdi S, Tavel D, Zahraei SM, Ghanaie RM, Heidary T, Goudarzi A, Kazemi A, Karimi A, Nateghian A, Ait-Ahmed M, Guiso N, Shahcheraghi F, Taieb F. Hospital-based prospective study of pertussis in infants and close contacts in Tehran, Iran. BMC Infect Dis 2021; 21:586. [PMID: 34144678 PMCID: PMC8212501 DOI: 10.1186/s12879-021-06266-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/01/2021] [Indexed: 11/30/2022] Open
Abstract
Background Pertussis remain a global health concern, especially in infants too young to initiate their vaccination. Effective vaccination and high coverage limit the circulation of the pathogen, yet duration of protection is limited and boosters are recommended during a lifetime. In Iran, boosters are given at 18 months and 6 years old using whole pertussis vaccines for which efficacy is not known, and pertussis surveillance is scant with only sporadic biological diagnosis. Burden of pertussis is not well understood and local data are needed. Methods Hospital-based prospective study implementing molecular laboratory testing in infants aged ≤6 months and presenting ≥5 days of cough associated to one pertussis-like symptom in Tehran. Household and non-household contact cases of positive infants were evaluated by comprehensive pertussis diagnosis (molecular testing and serology) regardless of clinical signs. Clinical evaluation and source of infection were described. Results A total of 247 infants and 130 contact cases were enrolled. Pertussis diagnosis result was obtained for 199 infants and 104 contact cases. Infant population was mostly < 3 months old (79.9%; 157/199) and unvaccinated (62.3%; 124/199), 20.1% (40/199) of them were confirmed having B. pertussis infection. Greater cough duration and lymphocyte counts were the only symptoms associated to positivity. Half of the contact cases (51.0%; 53/104) had a B. pertussis infection, median age was 31 years old. A proportion of 28.3% (15/53) positive contacts did not report any symptom. However, 67.9% (36/53) and 3.8% (2/53) of them reported cough at inclusion or during the study, including 20.8% (11/53) who started coughing ≥7 days before infant cough onset. Overall, only five samples were successfully cultured. Conclusion These data evidenced the significant prevalence of pertussis infection among paucy or poorly symptomatic contacts of infants with pertussis infection. Widespread usage of molecular testing should be implemented to identify B. pertussis infections. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06266-6.
Collapse
Affiliation(s)
- Gaelle Noel
- Center for Translational Science, Institut Pasteur, Paris, France.
| | - Masoumeh Nakhost Lotfi
- Department of Bacteriology, Pertussis Reference Laboratory, Pasteur Institute of Iran, Tehran, Islamic Republic of Iran
| | - Sajedeh Mirshahvalad
- Department of Bacteriology, Pertussis Reference Laboratory, Pasteur Institute of Iran, Tehran, Islamic Republic of Iran
| | - Sedaghatpour Mahdi
- Department of Bacteriology, Pertussis Reference Laboratory, Pasteur Institute of Iran, Tehran, Islamic Republic of Iran
| | - David Tavel
- Emerging Diseases Epidemiology unit, Institut Pasteur, Paris, France
| | - Seyed M Zahraei
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Islamic Republic of Iran
| | - Roxana Mansour Ghanaie
- Pediatric Infections Research Center, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Research Institute for Children's Health, Tehran, Islamic Republic of Iran
| | - Tahereh Heidary
- Department of Pediatrics, Ali Asghar children hospital, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Aliahmad Goudarzi
- Pediatric cardiology department, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Azardokht Kazemi
- Emergency Department, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Abdollah Karimi
- Pediatric Infections Research Center, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Research Institute for Children's Health, Tehran, Islamic Republic of Iran
| | - Alireza Nateghian
- Department of Pediatrics, Ali Asghar children hospital, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Mohand Ait-Ahmed
- Centre for Translational Science, Clinical Coordination, Institut Pasteur, Paris, France
| | - Nicole Guiso
- Center for Translational Science, Institut Pasteur, Paris, France
| | - Fereshteh Shahcheraghi
- Department of Bacteriology, Pertussis Reference Laboratory, Pasteur Institute of Iran, Tehran, Islamic Republic of Iran
| | - Fabien Taieb
- Center for Translational Science, Institut Pasteur, Paris, France.,Department of International Affairs, Institut Pasteur, Paris, France
| |
Collapse
|
2
|
Fu J, Ding Y, Jiang Y, Mo S, Xu S, Qin P. Persistent candidemia in very low birth weight neonates: risk factors and clinical significance. BMC Infect Dis 2018; 18:558. [PMID: 30419841 PMCID: PMC6233606 DOI: 10.1186/s12879-018-3487-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 10/31/2018] [Indexed: 01/13/2023] Open
Abstract
Background The prevalence and risk factors for persistent candidemia among very low birth weight infants are poorly understood. This study aimed to investigate the epidemiology of persistent candidemia over a 4-year period in a neonatal intensive care unit (NICU) in Liuzhou, China. Methods We retrospectively extracted demographic data, risk factors, microbiological results and outcomes of very low birth weight infants with candidemia in our hospital between January 2012 and November 2015. Persistent candidemia was defined as a positive blood culture for > 5 days. Logistic regression was used to identify risk factors associated with persistent candidemia. Results Of 48 neonates with candidemia, 28 had persistent candidemia. Both mechanical ventilation and intubation were significantly associated with increased rates of persistent candidemia (P = 0.044 and 0.004, respectively). The case fatality rate for the persistent candidemia group was 14.3%. Conclusion The rate of persistent candidemia was high among very low birth weight neonates. Mechanical ventilation and intubation were the major factors associated with the development of persistent candidemia. This study highlights the importance of intensive prevention and effective treatment among neonates with persistent candidemia.
Collapse
Affiliation(s)
- Jinjian Fu
- Department of Laboratory, Liuzhou Maternity and Child Healthcare Hospital, 50th Yingshan Road, Chengzhong District, Liuzhou, 545001, China.
| | - Yanling Ding
- Department of Laboratory, Liuzhou Maternity and Child Healthcare Hospital, 50th Yingshan Road, Chengzhong District, Liuzhou, 545001, China
| | - Yongjiang Jiang
- Department of Neonatology, Liuzhou Maternity and Child Health Care Hospital, Liuzhou, 545001, China
| | - Shengfu Mo
- Department of Laboratory, Liuzhou Maternity and Child Healthcare Hospital, 50th Yingshan Road, Chengzhong District, Liuzhou, 545001, China
| | - Shaolin Xu
- Department of Laboratory, Liuzhou Maternity and Child Healthcare Hospital, 50th Yingshan Road, Chengzhong District, Liuzhou, 545001, China
| | - Peixu Qin
- Department of Laboratory, Liuzhou Maternity and Child Healthcare Hospital, 50th Yingshan Road, Chengzhong District, Liuzhou, 545001, China
| |
Collapse
|
3
|
Sedighi I, Karimi A, Amanati A. Old Disease and New Challenges: Major Obstacles of Current Strategies in the Prevention of Pertussis. IRANIAN JOURNAL OF PEDIATRICS 2016; 26:e5514. [PMID: 27729960 PMCID: PMC5047029 DOI: 10.5812/ijp.5514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 04/26/2016] [Accepted: 05/23/2016] [Indexed: 11/20/2022]
Abstract
Context Universal immunization against Bordetella pertussis has partially controlled the burden of the disease and its transmission. However, according to recent data, the epidemiology of this vaccine-preventable disease has changed. Now, younger infants, adolescents, and adults are at greater risk of infection. This article has studied the interaction between the various factors involved in the changing epidemiology of pertussis and the major obstacles faced by the current strategies in its prevention. Evidence Acquisition In this narrative review, the most recently published sources of information on pertussis control measures, consisting of textbooks and articles, have been reviewed. We focused on the more recent data about the changing epidemiology or pertussis in Scopus through the use of the MeSH-term words [pertussis] or [whooping cough] and [epidemiology] or [outbreak] or [resurgence], but our search was not restricted to this particular strategy; we also tried to find all of the most recent available data in the general field through other means. Results Primary and booster doses of the pertussis vaccine seem to partially control transmission of the disease, but despite the different preventive strategies available, pertussis continues to cause mortality and morbidity among high-risk groups. Conclusions Adding booster doses of acellular pertussis vaccine to the current national immunization practices with whole-cell vaccines for young adults and pregnant women seems to be a good option for controlling mortality and morbidity among high-risk groups such as very young infants.
Collapse
Affiliation(s)
- Iraj Sedighi
- Department of Pediatrics, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Abdollah Karimi
- Pediatric Infections Research Center, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Ali Amanati
- Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
- Corresponding author: Ali Amanati, Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. E-mail:
| |
Collapse
|