ORIGINAL RESEARCH article
Front. Microbiol.
Sec. Infectious Agents and Disease
Co-infection in pediatric pertussis during 2023 and 2024 in southern China: pathogen distribution characteristic and influence on manifestation of pertussis
Provisionally accepted
- Guangdong Province Women and Children Hospital, Guangzhou, China
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Objective: We sought to examine the pathogen composition of co-infections in pertussis during 2023 and 2024 and assess the impacts of co-infection on pertussis. Methods: Clinical data of pediatric pertussis patients were retrospectively analyzed. The impact of co-infections on pertussis, the detection rate and composition of co-pathogens were analyzed. Culture, polymerase chain reaction, or metagenomic sequencing were used in pertussis or co-pathogens detection. Results: Among 620 pertussis patients, 110 patients co-infected with bacteria, 106 co-infected with virus, and 98 co-infected with both bacteria and virus. M. pneumoniae (114,18.39%), M. catarrhalis (44,7.1%), and H. influenzae (26,4.19%) were the most common bacterial co-pathogens, and Rhinovirus (100,16.12%), Cytomegalovirus (31,5%), and Influenza virus A&B (28,4.52%) were the most common viral co-pathogens. Patients with co-infections exhibited more severe manifestations than those with pertussis alone, and the severity was associated with the type and number of pathogens. The composition of co-pathogens linked to the age and hospitalization status of the patients. M. pneumoniae (91,21.06%), M. catarrhalis (32,7.41%), and Influenza virus A&B (22,5.09%) primarily caused co-infections in older, non-hospitalized patients, whereas Cytomegalovirus ((19,14.39%) non-ICU, (12, 21.43%) ICU) and Respiratory syncytial virus ((8,6.06%) non-ICU, (8,14.28%) ICU) were more common in younger, hospitalized patients. Conclusion: Co-infections are common among pertussis and can intensify clinical symptoms. Distribution of co-infecting pathogens is associated with age and hospitalization status, and the impacts of co-infection on the manifestations of pertussis varied according to the types and number of co-pathogens.
Keywords: Pertussis, Children, Co-infection, Symptoms, China
Received: 10 Oct 2025; Accepted: 20 Nov 2025.
Copyright: © 2025 Lai, Guo, Zhou, Luo, Zheng, Mai, Jiana 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, luo-my@163.com
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