국내 백일해감염 다기관 연구

Background: Limited data on the incidence and clinical characteristics of pertussis infections are available in Korea. Methods: Thirty-one hospitals and the Korean Centers for Disease Control and Prevention (KCDC) collaborated to investigate the incidence and clinical characteristics of pertussis infections among patients with a bothersome cough in non-outbreak, ordinary outpatient settings. Nasopharyngeal swabs were collected for polymerase chain reaction (PCR) and culture tests. Results: The study initially enrolled 622 patients between July 2011 and June 2012. Among them, 578 were finally included (age, 44.4±15.9 years; female, 415 [71.8%]), and their median cough duration was 15.0 days (interquartiles [IQR], 7.0-30.0 days). In total, thirty five (6.1%) patients were PCR positive for Bordetella pertussis, and among them, ten were also culture positive concurrently. The median age and cough duration were 39.0 (IQR, 26.0-48.0 years) and 14.0 days (7.0-21.0 days) among PCR-positive patients. Among clinical signs and symptoms, sputum, rhonchi, and post-tussive vomiting were more common in patients with a positive PCR than those without (p=0.005, p=0.007, and p=0.036, respectively), and in a multivariate analysis, sputum showed a significant association with PCR positivity (odds ratio, 2.937; 95% confidence interval, 1.101-7.839). Conclusions: The positive rate of pertussis infection was 6.1% in non-outbreak, ordinary clinical settings if a PCR-based method is used, and pertussis infections were associated with a high frequency of sputum.