Clinical Characteristics, Management and In-Hospital Outcomes of Children with Polymerase Chain Reaction (PCR)-Confirmed Pertussis at a Provincial Referral Hospital in Vietnam

Abstract

Background: Pertussis remains an important cause of hospitalization in young infants, particularly before completion of primary immunization. Methods: We conducted a single-center observational study of 36 consecutive children hospitalized with real-time polymerase chain reaction-confirmed Bordetella pertussis infection from 1 April 2024 through 31 March 2025. Demographic, vaccination, clinical, laboratory, radiographic, treatment and in-hospital outcome data were summarized. Because of the small sample and sparse outcome counts, associations with transfer to a higher-level hospital were assessed using two-sided Fisher exact tests and interpreted as exploratory. Results: The mean age was 13.73 months, 21 children (58.3%) were male and 13 (36.1%) were aged <2 months. Paroxysmal cough occurred in all children; facial flushing, mucus production, post-tussive vomiting and cyanosis/apnea occurred in 94.4%, 83.3%, 55.6% and 55.6%, respectively. Eight children (22.2%) developed respiratory failure. Absolute lymphocyte counts were ≥10 × 10⁹/L in 21 (58.3%). Macrolides were administered to all children. Thirty-three children (91.7%) were discharged from the study hospital and three (8.3%) were transferred. All transfers occurred among infants aged <2 months (3/13 vs 0/23; p = 0.040) and children with respiratory failure (3/8 vs 0/28; p = 0.008). Mean length of stay was 12.31 days (SD 5.74; range 2-30). Conclusion: In this small hospital cohort, very young age and respiratory failure were associated with transfer to a higher-level facility. The findings support close monitoring of young infants with pertussis but should be considered hypothesis-generating because of the single-center design and small number of transfer events.