ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Clinical Infectious Diseases
A Retrospective Study on Pediatric Pertussis: Comprehensive Evaluation of Symptoms, Laboratory Indicators, and Diagnostic Efficacy of Case Definitions
Provisionally accepted
Junfei Guo1
Weiming Lai1Qiongdan Mai1Yasha Luo1Minling Zheng1Yanting Qin2
Jiana Xiong2
Weixiang Wu1
Mingyong Luo1*- 1Guangdong Province Women and Children Hospital, Guangzhou, China
- 2Graduate school, Guangzhou Medical University, Guangzhou, China
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Objective: This study aimed to characterize the epidemiology of pertussis in children, evaluate the diagnostic performance of clinical and laboratory features, assess the effectiveness of different suspected-case criteria, and identify independent risk factors for ICU admission. Methods: We retrospectively analyzed demographic, clinical, and laboratory data from patients aged ≤14 years who underwent pertussis testing. Participants were stratified by test results, and the sensitivity and specificity of individual symptoms and laboratory parameters were calculated. Diagnostic performance was further assessed using univariate and multivariate logistic regression and nomogram analyses. Results: Among 2,015 children tested, 724 (35.9%) were positive for pertussis, with 187 (30.2%) hospitalized and 55 (8.9%) admitted to the ICU. Cases increased from August 2023, peaking in May 2024, with the majority aged 3–11 years (51.8%). Compared with B. pertussis–negative children, positive cases exhibited higher WBC counts and procalcitonin (PCT) levels. Incorporating PCT into the WHO suspected-case definition improved the ROC area from 0.710 to 0.870, with an optimal cutoff of 0.1665 ng/mL. Cyanosis, post-tussive vomiting, neutrophil count, and assisted ventilation emerged as independent predictors of ICU admission, with a neutrophil cutoff of 6.62 × 10⁹/L. Conclusion: The age distribution of pediatric pertussis shifted from young infants to preschool- and school-aged children. Clinical features alone are insufficient for reliable diagnosis due to overlap with non-pertussis cases. Elevated neutrophil count serves as an independent predictor of ICU admission, highlighting its potential utility for early risk stratification in pediatric pertussis.
Keywords: Children, China, Epidemiological features, Pertussis, Procalcitonin
Received: 03 Sep 2025; Accepted: 01 Dec 2025.
Copyright: © 2025 Guo, Lai, Mai, Luo, Zheng, Qin, Xiong, Wu and Luo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mingyong Luo
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