Parent-driven transmission, off-label SMZ-TMP, and severe pertussis prediction in infants under 2 months: a real-world observational cohort of 527 cases
Frontiers in Pediatrics·
- DOI
- 10.3389/fped.2026.1815371
- PMID
- —
- PMCID
- —
- OpenAlex
- —
- Study type
- Journal article
- Publisher
- Frontiers Media SA
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The findings provide context on reported household-source patterns, clinical features associated with severe disease, and treatment practices in hospitalized young infants with pertussis. The abstract may inform editorial discussion of vulnerable infant populations and antimicrobial management, but it does not establish population-wide prevalence or representativeness.
Structured evidence summary
Research question
The study examined the epidemiology, clinical characteristics, severity predictors, and antimicrobial management of hospitalized infants younger than 2 months with pertussis, including real-world use of SMZ-TMP in cases involving macrolide-resistant infection.
Study design
This was a retrospective observational study of PCR- or culture-confirmed pertussis cases hospitalized from 2015 through 2024. Logistic regression assessed factors associated with severe disease, and ROC analysis evaluated predictive performance.
Population and setting
The population comprised infants younger than 2 months hospitalized with pertussis at Shenzhen Children's Hospital. The study included 527 cases overall; exposure-source results were reported for 321 infants, and 25 infants aged 24–59 days received off-label SMZ-TMP.
Main findings
Among infants with documented exposure, parents were the most frequently reported infection source, accounting for 46.1% of cases. Several clinical and laboratory features, including apnea, reduced oxygen saturation, abnormal respiratory or heart rate, leukocytosis, and a higher neutrophil-to-lymphocyte ratio, were reported as significant correlates or predictors of severe pertussis. In 25 infants with macrolide-resistant infection who received SMZ-TMP, the abstract reports no bilirubin encephalopathy, renal dysfunction, or severe adverse reaction.
Public-health relevance
The findings provide context on reported household-source patterns, clinical features associated with severe disease, and treatment practices in hospitalized young infants with pertussis. The abstract may inform editorial discussion of vulnerable infant populations and antimicrobial management, but it does not establish population-wide prevalence or representativeness.
Important limitations
The retrospective, single-hospital design and restriction to hospitalized, laboratory-confirmed cases limit how directly the findings can be generalized beyond this setting and clinical population. The supplied evidence is limited to one article's abstract and metadata; the original paper is required for decision-grade interpretation of methods, comparison groups, statistical estimates, and outcome definitions.
GIDS interpretation
The article is discoverable as evidence concerning pertussis transmission context, treatment, and severity assessment in very young hospitalized infants. Its abstract does not provide evidence that it corresponds to, explains, or confirms a live surveillance signal.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 11 auditable classifier relationships to diseases, places, topics, and study design.