The Indian Journal of Pediatrics

, Volume 85, Issue 3, pp 189–193 | Cite as

Bordetella Pertussis Infection in Hospitalized Infants with Acute Bronchiolitis

  • Şule Gökçe
  • Zafer Kurugöl
  • S. Şöhret Aydemir
  • Candan Çiçek
  • Aslı Aslan
  • Güldane Koturoğlu
Original Article



To assess the frequency of B. pertussis infection among young infants hospitalized with acute bronchiolitis and to determine whether B. pertussis infection affects the clinical course of acute bronchiolitis.


A total of 172 infants <6 months of age hospitalized with acute bronchiolitis were tested for B. pertussis and respiratory viruses with real-time PCR. Cases were divided into 2 groups according to B. pertussis positive or negative. Clinical parameters, clinical severity scores and laboratory characteristics of the pertussis-positive and pertussis-negative cases were compared.


Bordetella pertussis infection was detected in 44 (25.6%) of the 172 infants hospitalized for acute bronchiolitis, and as co-infection with respiratory viral agents in 27 (61.4%) infants. Of the 44 pertussis-positive infants, only 17 (38.6%) experienced a paroxysmal cough, 13 (29.5%) had whooping and 15 (34.1%) had post-tussive vomiting. There was no significant difference between pertussis-positive and pertussis-negative infants according to Wang clinical score at admission (4.9 ± 1.5 vs. 5.2 ± 2.5; p = 0.689). The overall disease severity score was also similar between the two groups (6.5 ± 1.4 vs. 6.9 ± 1.6; p = 0.095).


Bordetella pertussis infection is common in young infants hospitalized for acute bronchiolitis, mostly as co-infection with respiratory viruses. The clinical features of pertussis in the infants are not characteristic. Viral bronchiolitis and pertussis cases could not be differentiated by clinical findings. Co-infection with pertussis did not affect the clinical outcome in infants hospitalized with acute bronchiolitis.


Bordetella pertussis Infant Acute bronchiolitis Respiratory viruses Disease severity score 



The authors would like to thank the study staff at the Microbiology Laboratory for conducting the study, and the infants and their families for participating in the study.


All the authors were involved in screening and management of cases. SG analyzed and drafted the manuscript. ZK and SSA critically reviewed and finalized the manuscript. ZK will act as guarantor for this paper.

Compliance with Ethical Standards

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or National Research Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The local ethics committee approved this study (reference number B.30.2.EGE.

Conflict of Interest


Source of Funding



  1. 1.
    Calvo C, Pozo F, García-García ML, et al. Detection of new respiratory viruses in hospitalized infants with bronchiolitis: a three-year prospective study. Acta Paediatr. 2010;99:883–90.CrossRefPubMedGoogle Scholar
  2. 2.
    Mansbach JM, Piedra PA, Teach SJ, et al. Prospective multicenter study of viral etiology and hospital length of stay in children with severe bronchiolitis. Arch Pediatr Adolesc Med. 2012;166:700–6.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Berry M, Gamieldien J, Fielding BC. Identification of new respiratory viruses in the new millennium. Viruses. 2015;7:996–1019.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Abu Raya B, Bamberger E, Kassis I, Kugelman A, Srugo I, Miron D. Bordetella pertussis infection attenuates clinical course of acute bronchiolitis. Pediatr Infect Dis J. 2013;32:619–21.CrossRefPubMedGoogle Scholar
  5. 5.
    Greenberg D, Bamberger E, Ben-Shimol S, Gershtein R, Golan D, Srugo I. Pertussis is under diagnosed in infants hospitalized with lower respiratory tract infection in the pediatric intensive care unit. Med Sci Monit. 2007;13:CR475–80.PubMedGoogle Scholar
  6. 6.
    Siberry GK, Paquette NR, Ross TL, Perl TM, Valsamakis A. Low prevalence of pertussis among children admitted with respiratory symptoms during respiratory syncytial virus season. Infect Control Hosp Epidemiol. 2006;27:95–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Korppi M, Hiltunen J. Pertussis is common in nonvaccinated ınfants hospitalized for respiratory syncytial virus ınfection. Pediatr Infect Dis J. 2007;26:316–8.CrossRefPubMedGoogle Scholar
  8. 8.
    Nuolivirta K, Koponen P, He Q, et al. Bordetella pertussis infection is common in nonvaccinated infants admitted for bronchiolitis. Pediatr Infect Dis J. 2010;29:1013–5.PubMedGoogle Scholar
  9. 9.
    Cosnes-Lambe C, Raymond J, Chalumeau M, et al. Pertussis and respiratory syncytial virus infections. Eur J Pediatr. 2008;167:1017–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Crowcroft NS, Booy R, Harrison T, et al. Severe and unrecognised: pertussis in UK infants. Arch Dis Child. 2003;88:802–8.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Ralston SL, Lieberthal AS, Meissner HC, et al. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics. 2014;134:e1474–502.CrossRefPubMedGoogle Scholar
  12. 12.
    Wang EE, Milner RA, Navas L, Maj H. Observer agreement for respiratory signs and oximetry in infants hospitalized with lower respiratory infections. Am Rev Respir Dis. 1992;145:106–15.CrossRefPubMedGoogle Scholar
  13. 13.
    Bamberger E, Srugo I, Abu Raya B, et al. What is the clinical relevance of respiratory syncytial virus bronchiolitis?: findings from a multi center prospective study. Eur J Clin Microbiol Infect Dis. 2012;31:3323–30.CrossRefPubMedGoogle Scholar
  14. 14.
    Nelson WL, Hopkins RS, Roe MH, Glode MP. Simultaneous infection with Bordetella pertussis and respiratory syncytial virus in hospitalized children. Pediatr Infect Dis. 1986;5:540–4.CrossRefPubMedGoogle Scholar
  15. 15.
    Walsh P, Overmeyer C, Kimmel L, et al. Prevalence of Bordetella pertussis and Bordetella parapertussis in Samples Submitted for RSV Screening. West J Emerg Med. 2008;9:135–8.PubMedPubMedCentralGoogle Scholar
  16. 16.
    Juretzko P, von Kries R, Hermann M, Wirsing von König CH, Weil J, Giani G. Effectiveness of acellular pertussis vaccine assessed by hospital-based active surveillance in Germany. Clin Infect Dis. 2002;35:162–7.CrossRefPubMedGoogle Scholar
  17. 17.
    Mooi FR, de Greeff SC. The case for maternal vaccination against pertussis. Lancet Infect Dis. 2007;7:614–24.CrossRefPubMedGoogle Scholar
  18. 18.
    Moshal KL, Hodinka RL, McGowan KL. Concomitant viral and Bordetella pertussis infections in infants. Pediatr Infect Dis J. 1998;17:353–7.CrossRefPubMedGoogle Scholar
  19. 19.
    Aoyama T, Ide Y, Watanabe J, Takeuchi Y, Imaizumi A. Respiratory failure caused by dual infection with Bordetella pertussis and respiratory syncytial virus. Acta Paediatr Jpn. 1996;38:282–7.Google Scholar
  20. 20.
    Tiwari T, Murphy TV, Moran J. Recommended antimicrobial agents for the treatment and postexposure prophylaxis of pertussis: 2005 CDC Guidelines. MMWR Recomm Rep. 2005;54:1–16.PubMedGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2017

Authors and Affiliations

  • Şule Gökçe
    • 1
  • Zafer Kurugöl
    • 2
  • S. Şöhret Aydemir
    • 3
  • Candan Çiçek
    • 3
  • Aslı Aslan
    • 1
  • Güldane Koturoğlu
    • 1
  1. 1.Department of Pediatrics, General Pediatrics UnitEge UniversityIzmirTurkey
  2. 2.Division of Pediatric Infection, Department of PediatricsEge UniversityIzmirTurkey
  3. 3.Department of MicrobiologyEge UniversityIzmirTurkey

Personalised recommendations