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To the Editor: Pertussis-like syndrome is a severe infectious respiratory disorder which might have the symptoms mimicking pertussis, including paroxysmal cough, inspiratory whoop, or post-cough vomiting [1]. The pathogens of pertussis-like syndrome mainly include Respiratory syncytial virus, Adenovirus, Haemophilus influenzae, Mycoplasma pneumoniae, or Streptococcus pneumonia [2]. Here we presente one case with pertussis-like syndrome caused by Acinetobacter pittii.
A 7-mo-old girl came to our hospital for persistent spasmodic cough over 2 wk after a journey. The capillary blood count (CBC) showed that white blood count (WBC) was 31.88×109/L and lymphocyte percentage was 72.7%. The serum C-reaction protein level was normal. Chest X-ray was not performed. She had taken three shots of DPT vaccine before. From the clinical findings, a diagnosis of pertussis-like syndrome was made. A throat swab specimen culture was done before starting antibiotics. Acinetobacter baumannii complex was detected and multilocus sequence typing (MLST) analyses were performed according to Pasteur scheme. The typing result showed the isolate was A. pittii ST119. The antimicrobial susceptibility test showed that it was sensitive to most common antibiotics except ceftriaxone. Azithromycin was given orally once a day (10 mg/kg) for 5 d. The cough symptom relieved gradually. The WBC turned to normal on follow-ups.
A. pittii is considered a pathogen of nosocomial infection, especially in intensive care units. It is seldom reported to give rise to community acquired infections. A. pittii is reported to cause cavitary pneumonia in a French patient with lupus [3]. A. pittii infections were also found in some COVID-19 patients [4]. However, our study was the first report to link pertussis-like syndrome to A. pittii ST119. To disclose the mechanism of A. pittii ST119 causing pertussis-like syndrome, further research is needed.
References
Gu W, Wang K, Zhang X, et al. Pathogen analysis of pertussis-like syndrome in children. BMC Infect Dis. 2020;20:353.
Saiki-Macedo S, Valverde-Ezeta J, Cornejo-Tapia A, et al. Identfication of viral and bacterial etiologic agents of the pertussis-like syndrome in children under 5 years old hospitalized. BMC Infect Dis. 2019;19:75.
Larcher R, Pantel A, Arnaud E, Sotto A, Lavigne J-P. First report of cavitary pneumonia due to community-acquired Acinetobacter pittii, study of virulence and overview of pathogenesis and treatment. BMC Infect Dis. 2017;17:477.
Mumcuoğlu İ, Çağlar H, Erdem D, et al. Secondary bacterial infections of the respiratory tract in COVID-19 patients. J Infect Dev Ctries. 2022;16:1131–7.
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Li, P., Fan, X. Pertussis-like Syndrome Caused by Acinetobacter pittii ST119. Indian J Pediatr 90, 1051 (2023). https://doi.org/10.1007/s12098-023-04728-0
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DOI: https://doi.org/10.1007/s12098-023-04728-0