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Expert consensus for pertussis in children:new concepts in diagnosis and treatment

摘要Background Pertussis resurgence has been reported worldwide in the past two decades.Pertussis is still endemic and dif-ficult to control though with universal vaccination in children.The resurgence may be related to multiple variables,such as increased disease awareness and laboratory tests,waning of immunity following vaccination,and/or genetic mutations of Bordetella pertussis.For better pertussis prevention,diagnosis,and management,we called up an expert panel to develop this expert consensus to provide new concepts in diagnosis and treatment for clinical practice.Data sources The expert groups collected clinical evidence,summarized their clinical experiences,evaluated preliminary recommendations or guidelines,and then organized open-ended discussions to form the recommendations.This consensus was developed by reviewing the literature and studies in databases,including PubMed,Cochrane,EMBASE,the China Biomedical Database,and the Chinese Journal Full-text Database up to May 2024.The search terms included"pertussis"or"whooping cough","children","diagnosis",and"treatment".Results The burden of pertussis has also changed from infants to school children and adults,and these age groups have consequently become the main source of infection for vulnerable population including infants and newborns.In China,a high prevalence of erythromycin-resistant Bordetella pertussis(ERBP)has been reported in the past decade.ERBP may lead to failed clinical empirical treatment with macrolides,which poses a great challenge for pertussis management and control.For better management of pertussis,a flow diagram for diagnosis and treatment of pertussis was presented in this consensus.This consensus also described the diagnostic criteria for pertussis,high-risk cases,and severe pertussis.Macrolides can still be used to treat confirmed erythromycin-sensitive B.pertussis(ESBP)infections,whereas oral trimethoprim-sulfamethoxa-zole therapy is the initial treatment option for children older than two months.For infants younger than two months,severe patients,or those exhibiting a high degree of sulfonamide allergy,intravenous administration of piperacillin or cefopera-zone-sulbactam is advised.Conclusions This expert consensus provides a comprehensive guidance and a reference for the diagnosis and treatment of pertussis in children.

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作者 Yu-Mei Mi [1] Ji-Kui Deng [2] Ting Zhang [3] Qing Cao [4] Chuan-Qing Wang [5] Sheng Ye [6] Ying-Hu Chen [1] Han-Qing He [7] Bei-Bei Wu [8] Yan Liu [9] Mei Zeng [10] Wei Li [11] Fang Wu [12] Hong-Mei Xu [13] Shi-Yong Zhao [14] Gang Liu [15] Wang Hua [1] Dan Xu [6] Guan-Nan Bai [1] Ying Yang [1] Li-Su Huang [1] Yi-Ping Chen [16] Kai-Hu Yao [17] Zhu-Jun Shao [18] Chun-Zhen Hua [1] 学术成果认领
作者单位 Department of Infectious Diseases,Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310052,China [1] Department of Infectious Diseases,Shenzhen Children's Hospital,Shenzhen 518038,China [2] Department of Infectious Diseases,School of Medicine,Shanghai Children's Hospital,Shanghai Jiao Tong University,Shanghai 200262,China [3] Department of Infectious Diseases,Shanghai Children's Medical Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China [4] Department of Nosocomial Infection Control,Department of Clinical Laboratory,Children's Hospital of Fudan University,Shanghai 201102,China [5] Department of General Intensive Care Medicine,Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310052,China [6] Department of Immunization Program,Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310052,China [7] Department of Microbiology,Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310052,China [8] Department of Immunization Program,Hangzhou Center for Disease Control and Prevention,Hangzhou,China [9] Department of Infectious Diseases,Children's Hospital of Fudan University,Shanghai 201102,China [10] Department of Clinical Laboratory,Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310052,Zhejiang,China [11] Department of Chinese Medicine,Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310052,China [12] Department of Infectious Diseases,Chongqing Children's Hospital,Chongqing 400015,China [13] Department of Infectious Diseases,Hangzhou Children's Hospital,Hangzhou 310014,China [14] Department of Infectious Diseases,Beijing Pediatric Research Institute,National Center for Children's Health,Beijing Children's Hospital,Capital Medical University,Beijing 100045,China [15] Department of Infectious Diseases,Yuying Children's Hospital of Wenzhou Medical College,Wenzhou 325003,China [16] Key Laboratory of Major Diseases in Children,Ministry of Education,National Clinical Research Center for Respiratory Diseases,National Key Discipline of Pediatrics,Laboratory of Infection and Microbiology,Beijing Pediatric Research Institute,National Center for Children's Health,Beijing Children's Hospital,Capital Medical University,NO.56 Nanlishi Road,Xicheng District,Beijing 100045,China [17] National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases,Chinese Center for Disease Control and Prevention,National Institute for Communicable Disease Control and Prevention,Changping,P.O.Box 5,Beijing 102206,China [18]
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DOI 10.1007/s12519-024-00848-5
发布时间 2025-03-05(万方平台首次上网日期,不代表论文的发表时间)
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