对伴有咳嗽的百日咳感染的韩国患者进行的多中心研究：基于PCR的研究
2013/02/28
摘要
背景：有关韩国成人百日咳感染的发病率和临床特征，目前的研究较为有限。
方法：31所医院和韩国疾病与预防控制中心协作，研究成人百日咳感染的发病率和临床特征，这些患者来自于非爆发季节的普通门诊，均出现咳嗽症状。收集鼻咽分泌物或鼻咽拭子检查收集分泌物，进行多聚酶链反应（PCR）和细菌培养。
结果：2009年9月～2011年4月之间的934名患者入选本研究。5名患者被诊断为百日咳感染，满足临床和实验室诊断标准（5人均为PCR阳性，1人同时细菌培养阳性）。在607名咳嗽病程至少2周的患者中，504名满足美国疾控中心的临床标准（可疑病例）。临床百日咳患者（可以病例和确诊病例）的年龄跨度较大（45.7±15.5岁），咳嗽病程较长（平均：30天；四分位间距：18.0～50.0天）。此外，痰液、鼻涕和肌痛很少见，呼吸困难在临床病例中更常见（分别为p=0.037, p=0.006, p=0.005,和p=0.030,）
结论：在非爆发季节的普通临床门诊中，PCR检测百日咳感染的阳性率较低。有必要进行前瞻性、设计优良的多中心研究。
(林江涛 审校)
TubercRespirDis(Seoul).2012Nov;73(5):266-72.doi:10.4046/trd.2012.73.5.266. Epub 2012 Nov 30.
A Multicenter Study of Pertussis Infection in Adults with Coughing in Korea: PCR-Based Study.
Park S, Lee MG, Lee KH, Park YB, Yoo KH, Park JW, Kim C, Lee YC, Park JS, Kwon YS, Seo KH, Kim HJ, Kwak SM, Kim JO, Lim SY, Sung HY, Jung SO, Jung KS.
Source
Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
Abstract
BACKGROUND: Limited data on the incidence and clinical characteristics of adult pertussis infections are available in Korea.
METHODS: Thirty-one hospitals and the Korean Centers for Disease Control and Prevention collaborated to investigate the incidence and clinical characteristics of pertussis infections among adults with a bothersome cough in non-outbreak, ordinary outpatient settings. Nasopharyngeal aspirates or nasopharyngeal swabs were collected for polymerase chain reaction (PCR) and culture tests.
RESULTS: The study enrolled 934 patients between September 2009 and April 2011. Five patients were diagnosed as confirmed cases, satisfying both clinical and laboratory criteria (five positive PCR and one concurrent positive culture). Among 607 patients with cough duration of at least 2 weeks, 504 satisfied the clinical criteria of the US Centers for Disease Control and Prevention (i.e., probable case). The clinical pertussis cases (i.e., both probable and confirmed cases) had a wide age distribution (45.7±15.5 years) and cough duration (median, 30 days; interquartile range, 18.0~50.0 days). In addition, sputum, rhinorrhea, and myalgia were less common and dyspnea was more common in the clinical cases, compared to the others (p=0.037, p=0.006, p=0.005, and p=0.030, respectively).
CONCLUSION: The positive rate of pertussis infection may be low in non-outbreak, ordinary clinical settings if a PCR-based method is used. However, further prospective, well-designed, multicenter studies are needed.
Tuberc Respir Dis (Seoul). 2012 Nov;73(5):266-72. doi: 10.4046/trd.2012.73.5.266. Epub 2012 Nov 30.
