目的:评估百日咳博德特氏菌(B。百日咳),B.副咳嗽,B.holmesii,和支气管败血病在中国百日咳复苏,尤其是最近一个冬天以来的大幅上涨。
方法:收集2018年1月至2024年3月百日咳样疾病患儿的鼻咽拭子进行培养,检测百日咳杆菌。B.副咳嗽,B.holmesii,和B.支气管败血症,并使用集中的实时聚合酶链反应(PCR)试剂盒针对插入序列ptxtS1,IS481,IS1001和hIS1001测试了除支气管败血杆菌以外的所有这些。
结果:在收集的7732个鼻咽拭子中,百日咳杆菌阳性1531例(19.8%,1531/7732),和10例阳性的B.perapertussis(0.1%,10/7732)。未检测到B.holmesii和B.chronchistica。百日咳杆菌的标本数量和检出率在2018年为1709%和26.9%(459/1709),在2019年为1936年和20.7%(400/1936年),在2020年急剧下降至308%和11.4%(35/308),在2021年为306和4.2%(13/306),然后在2022年,1842年和2196年第一季度(16.0%)分别上升至7研究期间百日咳病例中3岁至6岁以下(学龄前)和6岁至16岁(学龄期)的儿童比例显著增加,尤其是学龄儿童的比例从2018年的2.0%(9/459)上升至2024年的40.8%(80/196).
结论:B.百日咳是中国儿童百日咳样疾病的主要病原体,偶发性B.perapertussis和B.holmesii或B.bronchisepticon.学龄前和学龄儿童在百日咳杆菌感染病例中越来越普遍,这可能与百日咳疫情的最新快速升级有关。
OBJECTIVE: To evaluate the role of Bordetella pertussis (B. pertussis), B. parapertussis, B. holmesii, and B. bronchiseptica on pertussis resurgence in China, particularly the sharp rise since the latest winter.
METHODS: Nasopharyngeal swabs collected from children with pertussis-like illness from January 2018 to March 2024 were cultured to detect B. pertussis, B. parapertussis, B. holmesii, and B. bronchiseptica, and tested for all of these except for B. bronchiseptica using a pooled real-time polymerase chain reaction (PCR) kit targeting insertion sequences ptxS1, IS481, IS1001, and hIS1001.
RESULTS: Out of the collected 7732 nasopharyngeal swabs, 1531 cases tested positive for B. pertussis (19.8%, 1531/7732), and 10 cases were positive for B. parapertussis (0.1%, 10/7732). B. holmesii and B.bronchiseptica were not detected. The number of specimens and the detection rate of B. pertussis were 1709 and 26.9% (459/1709) in 2018, 1936 and 20.7% (400/1936) in 2019, which sharply declined to 308 and 11.4% (35/308) in 2020, 306 and 4.2% (13/306) in 2021, and then notably increased to 754 and 17.6% (133/754) in 2022, 1842 and 16.0% (295/1842) in 2023, 877 and 22.3% (196/877) in the first quarter of 2024. The proportion of children aged 3 to less than 6 years (preschool age) and 6 to 16 years (school age) in pertussis cases increased significantly during the study period, especially the proportion of school-aged children increased from 2.0% (9/459) in 2018 to 40.8% (80/196) in 2024.
CONCLUSIONS: B. pertussis was the predominant pathogen among children with pertussis-like illness in China, with sporadic detection of B. parapertussis and no detection of B. holmesii or B.bronchiseptica. The preschool and school-age children are increasingly prevalent in B. pertussis infection cases, which may be associated with the latest rapid escalation of pertussis outbreak.