Prague Med. Rep. 2018, 119, 61-69

Identification of Etiologic Agents of the Pertussis-like Syndrome in Children by Real-time PCR Method

Shima Mahmoudi1, Maryam Banar1, Babak Pourakbari1, Hediyeh Sadat Alavi2, Hamid Eshaghi2, Alireza Aziz Ahari3, Setareh Mamishi1,2

1Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
2Department of Infectious Diseases, Pediatrics Center of Excellence, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran
3Department of Radiology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran

Received November 14, 2017
Accepted March 21, 2018

The aim of this study was to recognize the identity and frequency of etiologic agents of the pertussis-like syndrome in children < 2 years of age. A cross-sectional hospital-based study conducted from August 2014 to August 2015. All children < 2 years of age (n=100) who were suspected as pertussis infected were enrolled in this study and tested for Bordetella pertussis, adenovirus (Adv), respiratory syncytial virus (RSV), human metapneumovirus (hMPV), and influenza virus A (INF-A) by real-time PCR technique. RSV was the most detected pathogen (20%), followed by B. pertussis (18%), Adv (16%), INF-A (11%), and hMPV (10%). Co-infection was observed in 8 patients (11%) and the combinations of RSV/INF-A (n=3, 4%), and AdV/B. pertussis (n=3, 4%) were more frequent. RSV, B. pertussis, and hMPV were more frequent pathogens among infants < 4 months of age. However, Adv and INF-A were more frequent pathogens among children > 6 months of age. In this study, RSV was the most frequent identified pathogen (n=20, 20%), followed by B. pertussis (n=18, 18%) and AdV (n=16, 16%). Pertussis was more frequent in spring (8%) and summer (6%). In addition, clinical symptoms of pertussis were the same as some viral pathogens, which can lead to misdiagnosis of infection. Therefore, diagnosis of pertussis should be established on the bases of both the clinical symptoms and the laboratory methods.


This study was supported by a grant (No. 94-03-88-29448) from Tehran University of Medical Sciences to Dr. Setareh Mamishi.


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