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[住院感染百日咳博德特氏菌的幼儿的感染源]

[Source of infection in young infants hospitalized with Bordetella pertussis].

作者信息

Perret Cecilia, Viviani Tamara, Peña Anamaría, Abarca Katia, Ferrés Marcela

机构信息

División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de ChileTemuco, Chile.

出版信息

Rev Med Chil. 2011 Apr;139(4):448-54. Epub 2011 Aug 25.

Abstract

BACKGROUND

Despite pertussis vaccination, very young infants have the highest rates of morbidity and mortality caused by the microorganism.

AIM

To determine the source of Pertussis infection in infants aged six months or less in Chile.

MATERIAL AND METHODS

Twenty six household contacts of 10 young infants hospitalized with confirmed Pertussis were studied for the presence of Bordetella Pertussis by polymerase chain reaction (PCR). Clinical and demographic data were analyzed.

RESULTS

Respiratory symptoms were present in 20 (77%) contacts, being cough the most common. Pertussis cases were identified in every household and in 18 (72%) of the household members. four members with B.pertussis were asymptomatic. Source of infection was identified in 80% (8/10) of the infant cases with ages ranging from 6 to 62 years. Half of primary cases had positive PCR and their cough duration was significantly shorter compared to primary cases with negative PCR.

CONCLUSIONS

B. pertussis transmission to young infants occurred mainly within the household where adults are generally the source of the infection. Risk factors for infant infection are the same as in developed countries. Therefore, the same strategies, such as routine vaccination in adolescents and adults or cocoon strategy, will help to prevent this disease in infants.

摘要

背景

尽管接种了百日咳疫苗,但非常小的婴儿因该微生物导致的发病率和死亡率最高。

目的

确定智利6个月及以下婴儿百日咳感染的来源。

材料与方法

对10例确诊为百日咳的住院幼儿的26名家庭接触者进行研究,通过聚合酶链反应(PCR)检测百日咳博德特氏菌的存在。对临床和人口统计学数据进行分析。

结果

20名(77%)接触者出现呼吸道症状,咳嗽最为常见。每个家庭都发现了百日咳病例,18名(72%)家庭成员感染。4名感染百日咳博德特氏菌的成员无症状。在80%(8/10)年龄在6至62岁的婴儿病例中确定了感染源。一半的原发性病例PCR呈阳性,与PCR阴性的原发性病例相比,其咳嗽持续时间明显更短。

结论

百日咳博德特氏菌主要在家庭内传播给幼儿,成年人通常是感染源。婴儿感染的危险因素与发达国家相同。因此,青少年和成人常规疫苗接种或“围裹”策略等相同策略将有助于预防婴儿患这种疾病。

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